Aminian, A, Sgueglia, GA, Wiemer, M, Kefer, J, Gasparini, GL, Ruzsa, Z, van Leeuwen, MAH, Ungureanu, C, Leibundgut, G, Vandeloo, B, Kedev, S, Bernat, I, Ratib, K, Iglesias, JF, Al Hage, E, Posteraro, GA, Pascut, D, Maes, F, Regazzoli, D, Kakonyi, K, Meijers, TA, Colletti, G, Krivoshei, L, Lochy, S, Zafirovska, B, Horák, D, Nolan, J, Degrauwe, S, Tobita, K and Saito, S (2022) Distal Versus Conventional Radial Access for Coronary Angiography and Intervention: The DISCO RADIAL Trial. JACC: Cardiovascular Interventions, 15 (12). 1191 - 1201. ISSN 1936-8798

[thumbnail of 1-s2.0-S1936879822008974-main.pdf]
1-s2.0-S1936879822008974-main.pdf - Published Version

Download (685kB) | Preview


BACKGROUND: Currently, transradial access (TRA) is the recommended access for coronary procedures because of increased safety, with radial artery occlusion (RAO) being its most frequent complication, which will increasingly affect patients undergoing multiple procedures during their lifetimes. Recently, distal radial access (DRA) has emerged as a promising alternative access to minimize RAO risk. A large-scale, international, randomized trial comparing RAO with TRA and DRA is lacking. OBJECTIVES: The aim of this study was to assess the superiority of DRA compared with conventional TRA with respect to forearm RAO. METHODS: DISCO RADIAL (Distal vs Conventional Radial Access) was an international, multicenter, randomized controlled trial in which patients with indications for percutaneous coronary procedure using a 6-F Slender sheath were randomized to DRA or TRA with systematic implementation of best practices to reduce RAO. The primary endpoint was the incidence of forearm RAO assessed by vascular ultrasound at discharge. Secondary endpoints include crossover, hemostasis time, and access site-related complications. RESULTS: Overall, 657 patients underwent TRA, and 650 patients underwent DRA. Forearm RAO did not differ between groups (0.91% vs 0.31%; P = 0.29). Patent hemostasis was achieved in 94.4% of TRA patients. Crossover rates were higher with DRA (3.5% vs 7.4%; P = 0.002), and median hemostasis time was shorter (180 vs 153 minutes; P < 0.001). Radial artery spasm occurred more with DRA (2.7% vs 5.4%; P = 0.015). Overall bleeding events and vascular complications did not differ between groups. CONCLUSIONS: With the implementation of a rigorous hemostasis protocol, DRA and TRA have equally low RAO rates. DRA is associated with a higher crossover rate but a shorter hemostasis time.

Item Type: Article
Additional Information: The final version of this article and all relevant information related to it, including copyrights, can be found on the publisher website.
Subjects: R Medicine > R Medicine (General)
R Medicine > R Medicine (General) > R735 Medical education. Medical schools. Research
Divisions: Faculty of Medicine and Health Sciences > School of Pharmacy and Bioengineering
Related URLs:
Depositing User: Symplectic
Date Deposited: 11 Nov 2022 11:18
Last Modified: 11 Nov 2022 11:18

Actions (login required)

View Item
View Item