Distal radial access for routine consideration in coronary angiography-safety and feasibility study

Background: Traditionally transfemoral and proximal radial access sites are chosen for percutaneous coronary intervention (PCI) but both these access sites have periprocedural complications with respect to bleeding and radial artery occlusion respectively. Distal radial arterial access has advantages over the two in terms of patient comfort and almost nil periprocedural complications including radial artery occlusion (as the access is distal to the palmar arch) and preservation of proximal radial artery for future procedures like chronic haemodialysis and bypass graft conduit. This study sought to determine the safety, feasibility and advantages of the distal radial artery as routine access site for percutaneous coronary interventions.Methods: Between March and August 2019 a total of 70 patients were taken up for distal radial intervention (33 only CAG (coronary angiography), 37 adhoc PCI) after obtaining written informed consent before procedure.Results: Of all the patients undergone CAG and PCI the success rate for puncture and access was 94% with 4 failures with crossover to proximal radial thereof. Periprocedural course remained uneventful and radial pulse palpable well in both distal and proximal course at the time of discharge. Follow-up for further 1 months also showed no access site related complications.Conclusions: Among patients undergoing PCI distal radial access is definitely a low risk, feasible procedure without any periprocedural complications. It should, therefore be recommended the first-choice access site for all PCI procedures.