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EFFICACY AND SAFETY OF THE DISTAL TRANSRADIAL APPROACH IN PERCUTANEOUS CORONARY INTERVENTION
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Abstract
Background: The distal transradial approach represents a new entry method into the artery in coronary angiography and PCI, offering more advantages than traditional radial artery access, such as reducing the risk of radial artery occlusion, lower hematoma formation, preserving the radial artery for future vascular surgeries, and increasing comfort for the patient. Objectives: To determine the success rate of accessing the distal segment of the radial artery in coronary angiography and percutaneous coronary intervention, as well as the rate of local complications after the procedure during hospitalization. Methods: This is a retrospective, observational descriptive study in patients indicated for coronary angiography and intervention via distal transradial access at Gia Dinh People's Hospital from June 2023 to June 2024. Results: A sample of 290 patients was collected, of which over 50% were patients with ACS, including 54 patients with STEMI, accounting for 18.6%. The success rate of needle puncture was 94.8% (275/290), and the procedure completion rate was 91.7% (266/290). 9 patients required a conversion of access route due to radial artery spasm, representing 3.27%. The rate of local complications after the procedure was very low at only 0.7% (2/290), all classified as EASY I grade hematoma. The rate of intervention for complex lesions, including intervention of the left main coronary artery, bifurcation lesions, and chronic total occlusions, was 0.9%, 2.6%, and 1.7%, respectively. The use of physiological assessment and imaging tools such as FFR, IVUS, and OCT was 1.5%, 1.1%, and 0.7%, respectively. Conclusions: Distal radial artery access is a viable option in percutaneous coronary intervention, with a success rate of over 90% and a very low rate of local complications. Additionally, it allows for the performance of complex interventional procedures or the use of advanced physiological assessment and imaging tools through the distal radial artery.
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Keywords
Interventional Cardiology, Distal transradial access
References
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