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经皮冠状动脉介入治疗中桡动脉远端入路的评估。对照、随机非劣效性试验。

Evaluation of the Distal Radial Approach in percutaneous coronary interventions. Controlled, randomized non-inferiority trial.

出版信息

Tunis Med. 2022;100(3):192-202.

Abstract

RESEARCH PROBLEM

The conventional radial approach is the recommended vascular access for percutaneous coronary interventions. It is effective and feasible but associated with a risk of occlusion of the radial artery. The distal radial approach is proposed as a new approach to reduce complications and preserve the radial artery. However, few clinical trials in real life were conducted in North African patients. This trial aims to evaluate the efficacy and safety of the distal radial approach versus the conventional radial approach. Investigative process : This trial is a non-inferiority, randomized controlled trial with two parallel arms: distal radial approach and conventional radial approach. Two hundred fifty patients scheduled for percutaneous coronary intervention will be included. The two main endpoints are the puncture success rate with a non-inferiority margin of 10% and the occlusion rate of the punctured radial artery attributed to the end of hemostasis and to 30 days. Secondary Endpoints : catheterization success, crossover rate, procedure time, radial artery spasm, bleeding complications, QuickDASH pain score, Operator satisfaction. A single blind analysis will be led according to the per-protocol and intention-to-treat methods.

RESEARCH PLAN

Ethical considerations will be undertaken and respected. This trial will run for four months from February 2022. The results will provide parameters related to the efficacy and safety of the distal radial approach, improving clinical practice.

TRIAL REGISTRATION

NCT05311111.

摘要

研究问题

传统的桡动脉入路是经皮冠状动脉介入治疗的推荐血管通路。它是有效且可行的,但与桡动脉闭塞的风险相关。远端桡动脉入路被提议作为一种新的方法来减少并发症并保留桡动脉。然而,在北非患者中进行的很少有真实世界的临床试验。本试验旨在评估远端桡动脉入路与传统桡动脉入路的疗效和安全性。研究过程:本试验是一项非劣效性、随机对照试验,分为两个平行组:远端桡动脉入路和传统桡动脉入路。将纳入 250 名计划接受经皮冠状动脉介入治疗的患者。两个主要终点是穿刺成功率,非劣效性边界为 10%,以及归因于止血结束和 30 天的穿刺桡动脉闭塞率。次要终点:导管插入术成功率、交叉率、手术时间、桡动脉痉挛、出血并发症、QuickDASH 疼痛评分、操作者满意度。将根据方案和意向治疗方法进行单盲分析。

研究计划

将进行并尊重伦理考虑。本试验将从 2022 年 2 月开始进行四个月。结果将提供与远端桡动脉入路的疗效和安全性相关的参数,改善临床实践。

试验注册

NCT05311111。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/da64/9387641/b3c7241ced6a/image1.jpg

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