National Clinical Research Center for Cardiovascular Disease, State Key Laboratory of Cardiovascular Disease, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.
Shihezi People's Hospital, The Third Affiliated Hospital of Shihezi University School of Medicine, Xinjiang, China.
Cardiovasc Ther. 2023 May 16;2023:2560659. doi: 10.1155/2023/2560659. eCollection 2023.
The distal transradial access (dTRA) is a new puncture site for coronary catheterization. We sought to evaluate the feasibility, safety, and complication rates of using the dTRA for cardiac catheterization in Chinese patients.
A total of 263 consecutive patients who underwent catheterization through the dTRA were enrolled. The primary endpoint of the study was the rate of conversion to another access site due to the impossibility of successful artery puncture or intubation. Secondary safety endpoints were the rates of bleeding-related complications and nerve disorders.
Among 263 patients, the puncture success rate was 96.2% (253/263). Eleven patients were successfully punctured, but the guide wire was difficult to advance. One patient had intubation failure, and the success rate of intubation was 91.6% (241/263). Two hundred thirty-three patients underwent puncture via the right dTRA, 5 patients underwent puncture via the left dTRA, and 3 patients underwent puncture via the bilateral dTRA. A total of 158 (65.6%) patients underwent coronary angiography, and 83 (34.4%) patients underwent percutaneous coronary intervention. After the procedure, only 2 (0.8%) patients had mild bleeding at the puncture site, 2 (0.8%) had a forearm hematoma, and no patient had a nerve disorder.
DTRA has a low incidence of complications, making it a safe and effective technique for cardiac catheterization.
远端桡动脉入路（dTRA）是一种新的冠状动脉导管插入术穿刺部位。我们旨在评估中国患者经 dTRA 进行心脏导管插入术的可行性、安全性和并发症发生率。
共纳入 263 例连续经 dTRA 进行导管插入术的患者。该研究的主要终点是因动脉穿刺或插管无法成功而转换为其他入路的比例。次要安全性终点是出血相关并发症和神经障碍的发生率。
在 263 例患者中，穿刺成功率为 96.2%（253/263）。11 例患者穿刺成功，但导丝难以推进。1 例患者插管失败，插管成功率为 91.6%（241/263）。233 例患者经右侧 dTRA 穿刺，5 例患者经左侧 dTRA 穿刺，3 例患者经双侧 dTRA 穿刺。共 158 例（65.6%）患者行冠状动脉造影，83 例（34.4%）患者行经皮冠状动脉介入治疗。术后仅 2 例（0.8%）患者穿刺部位出现轻度出血，2 例（0.8%）患者出现前臂血肿，无患者出现神经障碍。
dTRA 并发症发生率低，是一种安全有效的心脏导管插入术技术。
