The distal (SnUffbox) versus Proximal radial artERy access for coronary angiography and interventions Registry (SUPER-Registry)
Presenter
Sebastian Carrasquillo, M.D., First Coast Heart & Vascular Center, jacksonville, FL
Sebastian Carrasquillo, M.D.1, Allen Brown, M.D.2, Jose Ruiz-Morales, M.D.3, Kerolos Fahmi, M.D.4, Christopher Degrout, M.D.5, Jainil Jatin Shah, M.B.B.S.6, Ismael Ortiz Cartagena, M.D., FSCAI7, Naji Maaliki, M.D.5, Pooja Dhruva, M.D.5 and Andres Mauricio Pineda, MD, FSCAI8, (1)First Coast Heart & Vascular Center, jacksonville, FL, (2)George Washington University Hospital, Washington, DC, (3)Mayo Clinic Florida, Jacksonville, FL, (4)UF Health Jacksonville, Palm Harbor, FL, (5)University of Florida College of Medicine-Jacksonville, Jacksonville, FL, (6)Jefferson Regional Medical Center, Little Rock, AR, (7)Pavia Santurce, Canovanas, PR, (8)Duke University Hospital, Chapel Hill, NC
Keywords: Coronary and Vascular Access, Management, and Closure
Background
Distal radial artery access has emerged as an alternative to the standard proximal radial access for coronary angiography. As the use of this novel technique is expanding, a prospective randomized study to assess its safety and feasibility is warranted.
Methods
This study had a consecutive case series design. We enrolled 100 patients to undergo left heart catheterization via the distal radial artery at the distal portion of the anatomic snuffbox. The primary endpoint was the incidence rates of access site-related complications defined as radial artery occlusion, radial artery vasospasm, other access site-related bleeding or vascular complications, or hand dysfunction. Secondary endpoints included patient satisfaction and access success rate.
Results
The distal radial artery access success rate was 86%. 2% of these patients suffered radial artery occlusion, and 15% experienced radial artery spasms. There was a 0% minor or major bleeding complication rate. Vascular complications only included a 2% accidental venipuncture and a 3% hematoma formation rate, with no major complications. 3% of the subjects reported post-procedural hand dysfunction. While access success rate was less than that of proximal access, comparably lower complication rates were found. Notably, patient satisfaction was high, with 92% of patients recommending the distal approach.
Conclusions
This study of 100 left heart catheterizations displays the advantages of distal radial artery access as seen by a low complication rate, along with a high satisfaction and success rate. This supports the need for a randomized, double-blinded trial comparing the two access methods.
