Koziński Łukasz, Orzałkiewicz Zbigniew, Zagożdżon Paweł, Dąbrowska-Kugacka Alicja
Department of Cardiology, Chojnice Specialist Hospital, Lesna 10, 89-600 Chojnice, Poland.
Department of Hygiene and Epidemiology, Medical University of Gdansk, Debinki 7, 80-211 Gdansk, Poland.
Diagnostics (Basel). 2024 Sep 20;14(18):2081. doi: 10.3390/diagnostics14182081.
The distal transradial approach (dTRA) is increasingly used in interventional cardiology. Doppler Ultrasound (DUS) effectively assesses radial artery (RA) characteristics. This study aims to identify specific RA DUS characteristics in patients undergoing coronary procedures via dTRA. : Participants from the ANTARES trial who completed the intervention per-protocol and retained RA patency were included. DUS was performed at baseline, 1 day, and 60 days post-procedure. : Among 400 participants, 348 had either dTRA (n = 169) or conventional transradial access (cTRA) (n = 179). Distal RA lumen diameter was 12% smaller than that of the proximal RA ( < 0.001). Men had a 14% larger distal RA diameter than women (2.33 ± 0.31 mm vs. 2.04 ± 0.27 mm, < 0.0001), similar to the proximal RA relationship. Peak flow velocities were similar between the sexes. Univariate linear regression showed that height, weight, body mass index, and body surface area (BSA) predicted arterial size, with BSA remaining significant in multivariate analysis (beta coefficient 0.62; confidence interval 0.49-0.75; < 0.0001). Distal RA diameter correlated positively with palpable pulse at the snuffbox and wrist. The dTRA resulted in an immediate 14% and 11% increase in distal and proximal RA diameter, respectively (both < 0.05). Sixty days after dTRA, the distal RA remained slightly dilated ( < 0.05), while the proximal RA returned to baseline. : Distal RA diameter is significantly associated with sex, measuring smaller than the forearm segment. A strong palpable pulse correlates with larger distal RA size. The dTRA induces RA lumen expansion. A thorough understanding of distal RA anatomy is essential for optimizing patient selection and refining techniques for transradial procedures.
远端桡动脉入路（dTRA）在介入心脏病学中的应用日益广泛。多普勒超声（DUS）可有效评估桡动脉（RA）特征。本研究旨在确定经dTRA行冠状动脉手术患者的特定RA DUS特征。：纳入ANTARES试验中按方案完成干预且保留RA通畅的参与者。在基线、术后1天和60天进行DUS检查。：在400名参与者中，348名采用了dTRA（n = 169）或传统桡动脉入路（cTRA）（n = 179）。远端RA管腔直径比近端RA小12%（<0.001）。男性的远端RA直径比女性大14%（2.33±0.31mm对2.04±0.27mm，<0.0001），与近端RA的情况相似。两性之间的峰值流速相似。单变量线性回归显示，身高、体重、体重指数和体表面积（BSA）可预测动脉大小，多变量分析中BSA仍具有显著性（β系数0.62；置信区间0.49 - 0.75；<0.0001）。远端RA直径与鼻烟壶处和腕部可触及脉搏呈正相关。dTRA导致远端和近端RA直径分别立即增加14%和11%（均<0.05）。dTRA术后60天，远端RA仍略有扩张（<0.05），而近端RA恢复至基线水平。：远端RA直径与性别显著相关，比前臂段小。强烈的可触及脉搏与较大的远端RA尺寸相关。dTRA可诱导RA管腔扩张。深入了解远端RA解剖结构对于优化经桡动脉手术的患者选择和改进技术至关重要。
