The benefit of the transradial approach in percutaneous interventions is well known. Its main limitation is radial artery occlusion (RAO) which would compromise the artery for future use in percutaneous procedures. Even though it is clinically silent, reported cases might reach 33%.
More recently, the distal radial access (DRA) has surged as an alternative to reduce RAO. However, its safety and potential to produce negative effects in hand function have not been studied yet.
The aim of this prospective, multicenter, cohort study was to assess hand function at long term in patients treated with DRA for coronary procedures.
Multiple outcomes were presented to assess hand dysfunction, including coordination questionnaires, dexterity, strength, and sensation tests up to 12-month followup.
The study looked at 313 patients. Mean age was 66 and they were mostly men. 22% presented prior radial access. As regards procedure characteristics, 54% of DRA was left, ultrasound was used to guide puncture in 85 % of cases, and they were mostly diagnostic procedures. DRA failed in 2.9% of cases.
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DRA showed no hand function deterioration according to the questionnaires for subjective and objective assessment and was even associated to less pain and <1% RAO rate.
Conclusion
The distal radial access was not associated with worse hand function. On the contrary, it was associated to lower complications rate with good tolerance to the procedure.
Dr. Andrés Rodríguez
Member of the editorial board of SOLACI.org.
Original Title: International Hand Function Study Following Distal Radial Access The RATATOUILLE Study.
Reference: Gregory A. Sgueglia, MD et al J Am Coll Cardiol Intv 2022.
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