Work

CORRECT RADIAL RCT. CORonaRy angiography and intErventions via distal vs proximal transradial aCcess—a randomized Trial of different RADIAL puncture sites

Year: 2025

Type: article

Study designs: Randomized Controlled Trial, Clinical Trial

Abstract: BACKGROUND: Transradial access (TRA) is recommended as the primary route for coronary angiography (CAG) and percutaneous coronary intervention (PCI). In recent years, a more distal puncture site in the area of the anatomical snuffbox (distal radial access; dRA) has been established. In this randomized multicenter trial, we aim to demonstrate the superiority of dRA with respect to the rate of radial artery occlusion (RAO) compared with the traditional proximal radial access (pRA). METHODS: Patients scheduled for CAG or PCI in five cardiology centers in Germany were randomized for standard pRA or dRA. The primary endpoint was a reduced rate of RAO (superiority) after 30 days. Secondary endpoints included crossover rate, hand function assessed by QuickDASH test, duration of the puncture and procedure, and the puncture success rate. Proximal and distal radial artery patency was examined by ultrasound within 48 h and after 30 days. RESULTS: A total of 254 patients were enrolled (mean age: 66 ± 10 years, 71% male gender, 48% PCI). The trial was halted prematurely after 50% of the planned population. The primary endpoint was numerically reduced in the dRA group (N = 1/128; 0.9%) compared with the pRA group (N = 3/126, 2.8%), but the difference was not statistically significant (P = 0.36). Puncture success was high in both arms (N = 240/254, 94%) and no statistically significant difference between the two puncture sites (dRA: 91%; pRA: 98%) was observed. Major complications were not encountered. CONCLUSION: The rate of radial artery occlusion after dRA for coronary intervention was not significantly reduced compared with pRA. TRIAL REGISTRATION: This study is registered in ClinicalTrials: NCT04194606.

Source: Clinical Research in Cardiology

DOI: 10.1007/s00392-025-02759-5