P4398
Snuff-box versus distal forearm for trans-radial access: performance and radial patency

Extract

Background: Distal right radial approach (dRRA) in anatomical snuff-box might reduce the probability of radial artery occlusion (RAO) in distal forearm. Furthermore, it allows more comfortable hand position, particularly in obese patients.

Purpose: To evaluate dRRA compared to conventional right radial approach (cRRA) in patients treated trans-radially.

Methods: Prospective, single-center, randomised, open label study. Primary end-point was RAO in forearm evaluated on discharge by ultrasonography, while secondary endpoints included procedural success, fluoroscopy time, and homeostasis time. 114 eligible patients were randomised 1:1 into dRRA and cRRA groups. Overall mean age was 63.42 years, 58% were males and PCI was performed in 32% of patients. Both groups had similar clinical and angiographic characteristics. 6F sheath and standard catheters were used, homeostasis device was verified after 1 hour then on 30-minutes' interval in all patients.

Results: No patient in dRRA group had RAO in forearm versus 3 patients in cRRA group (0% vs. 6%, p<0.01). Procedural success and fluoroscopy time were similar in both groups, however time needed for hemostasis was significantly lower in dRRA group than cRRA group (83.52 vs. 139.8 minutes, p=0.021). Neither patient suffered forearm ischemia or change in right-hand function.