Feasibility and safety of distal radial artery access in elderly patients: From KODRA registry

Background The distal radial access (DRA) was shown to be feasible, safe, and associated with a lower rate of radial artery occlusion and a shorter hemostasis time compared with conventional radial access in several studies, but there is a lack of data regarding elderly patients. This study aimed to investigate the feasibility and safety of DRA in elderly patients from large prospective multi-center observational registry. Methods A total of 4941 patients in Korean prospective registry for evaluating the safety and efficacy of Distal Radial Approach (KODRA) were analyzed. The patients were divided into less and over than 70 years. The primary efficacy endpoint was defined as successful puncture with completion of the coronary procedure without crossover. The primary safety endpoints were composite of DRA-related bleeding and access-site complications. Results The patients less than 70 years were 2850 and over than 70 years were 2091. Mean age was 58.3±8.3 in <70 years and 77.5±5.2 in ≥70 years. Body mass index and body surface area were significantly higher in <70 years. Puncture success rate was significantly higher in ≥70 years than in <70 years (93.8% vs. 95.2%, p=0.033), but access crossover rate was not different between two groups. Compared to the patients <70 years, the primary efficacy endpoint of the patients ≥70 years was comparable (OR 1.054; 95% CI 0.831-1.337; p=1.054). The primary safety endpoints of the patients ≥70 years was also not different compare to the patients <70 years (OR 1.105; 95% CI 0.856-1.425; p=0.445). Conclusion The DRA is feasible and safe in elderly patients.