Apostolos Anastasios, Papanikolaou Amalia, Papageorgiou Angeliki, Moulias Athanasios, Vasilagkos Georgios, Pappelis Konstantinos, Aminian Adel, Sgueglia Gregory A, Iglesias Juan F, Davlouros Periklis, Tsigkas Grigorios
Department of Cardiology, University Hospital of Patras, Patras, Greece.
First Department of Cardiology, Medical School, National and Kapodistrian University, Hippocration Hospital of Athens, Athens, Greece.
J Vasc Access. 2025 Sep;26(5):1724-1731. doi: 10.1177/11297298241296570. Epub 2024 Dec 6.
Distal radial artery access (DRA) has been emerged as an alternative for conventional transradial arterial access. While palpation of radial artery is mandatory prior coronary angiography, it remains unknown the clinical impact of palpation in DRA success. Aim of our study is to explore whether the palpability of distal radial artery is linked with higher rates of successful arterial access.
We conducted a post-hoc analysis using data from two randomized-controlled trials on DRA. All patients with available data on distal radial artery palpability and cannulation's success were included in our analysis. No procedure was performed with ultrasound guidance.
Data on the palpability of the distal radial artery and the DRA success were available for 435 patients. Successful distal radial artery cannulation was attempted in 255 and 98 of patients with and without palpable distal radial artery, respectively. No significant difference between the two groups was observed (81.5% vs 80.3%, = 0.786). Univariate analysis revealed statistically significant difference in gender, height, known CAD, valvular disease as indication for angiography and number of skin punctures. Multivariate analysis included these variables, as well as palpability of the distal radial artery and found that number of skin punctures and valvular disease as indication are significantly associated with DRA success.
According our post-hoc analysis, the palpability of the distal radial artery is not associated with higher rates of DRA success. Further studies are required for the validation of these results.
桡动脉远端入路（DRA）已成为传统经桡动脉入路的一种替代方法。虽然在冠状动脉造影前必须触诊桡动脉，但触诊对DRA成功的临床影响尚不清楚。我们研究的目的是探讨桡动脉远端的可触知性是否与更高的动脉穿刺成功率相关。
我们使用两项关于DRA的随机对照试验的数据进行了事后分析。所有有桡动脉远端可触知性和穿刺成功相关可用数据的患者都纳入了我们的分析。所有操作均未在超声引导下进行。
435例患者有桡动脉远端可触知性和DRA成功相关的数据。分别对255例有和98例无桡动脉远端可触及的患者尝试进行桡动脉远端成功穿刺。两组之间未观察到显著差异（81.5%对80.3%，P = 0.786）。单因素分析显示，在性别、身高、已知冠心病、作为血管造影指征的瓣膜病和皮肤穿刺次数方面存在统计学显著差异。多因素分析纳入了这些变量以及桡动脉远端的可触知性，发现皮肤穿刺次数和作为指征的瓣膜病与DRA成功显著相关。
根据我们的事后分析，桡动脉远端的可触知性与DRA成功率较高无关。需要进一步研究来验证这些结果。
