Comparison Of Distal Transradial Artery Access And Transradial Artery Access For Coronary Intervention Study Of Complications Of Access

Background:Transradial artery access(TRA)is superior to transfemoral approach(TFA)because of its safety and simplicity,and it has been successfully replaced as the current preferred path for coronary interventional diagnosis and treatment.Radial artery occlusion(RAO)is considered to be the "Achilles heel" of TRA,which limits the use of the radial artery and makes it completely impossible to use this artery for secondary interventional procedures,arteriovenous fistulization dialysis in patients with end-stage renal disease,and coronary artery bypass grafting.The emergence of distal distal transradial artery access(d TRA)compensates for this fatal defect,and d TRA can significantly reduce the incidence of RAO,preserve the integrity of the radial artery,and make it possible to use it again,followed by significantly shortened postoperative compression time of d TRA,which is superior to TRA in safety and comfort and is expected to replace TRA as a new generation of preferred path.Objective:This study intends to compare the complications associated with Distal transradial artery access(d TRA)and transradial artery access(TRA)for coronary interventional diagnosis and treatment.,and to explore the superiority of d TRA compared with TRA in PCI.Methods:From March 2022 to March 2023,patients scheduled for coronary angiography(CAG)or percutaneous coronary intervention(PCI)were hospitalized in the Coronary Diagnosis and Treatment Center of Jiangxi Provincial People ’s Hospital.Eligible patients were randomly divided into transradial artery access(TRA)group and distal transradial artery access(d TRA)group according to the ratio of 1:1.TRA group: transradial artery access was selected for coronary interventional diagnosis and treatment.;d TRA group: distal radial artery approach was selected for coronary interventional diagnosis and treatment.The baseline clinical data,surgical and postoperative relevant data of all selected cases were collected.The data were uniformly analyzed by IBM SPSS 25.0 software.The intraoperative puncture and postoperative complications were compared between the two groups.The results were considered statistically significant at P < 0.05.Result:Two hundred and six patients were randomized 1:1 to d TRA(103 patients)and TRA(103 patients),and the incidence of RAO did not differ between the two groups(0% vs 0.97%,P = 1.0).Compared with TRA,d TRA required a higher number of punctures [median = 2(1-3)vs median = 1(1-2),P < 0.001],longer puncture time(120 vs 75 seconds,P < 0.001),more arterial spasm(9.71% vs 2.91%,P = 0.045),shorter median time to hemostasis(120 vs 180 minutes,P = 0.001),and lower median NRS grade for pain(2 vs 3,P = 0.004).No significant differences were observed in the remaining minor complications.Conclusion:With the implementation of comprehensive RAO prevention strategies,TRA and d TRA performed similarly in terms of RAO incidence.However,compared with TRA,d TRA can reduce the duration of continuous compression at the puncture site after surgery,with higher comfort and less postoperative complications,which complement each other.