Distal radial artery palpability and cannulation success for coronary procedures

Background Distal transradial access (DRA) is increasingly performed for coronary angiography and interventions, due to lower incidence of radial artery occlusion, faster hemostasis and decreased local complications rate. However, higher rates of crossover to other access sites remains the major limitation of DRA and the optimal technique for achieving successful cannulation remains under investigation. Purpose Aim of our analysis is to explore whether a palpable distal radial artery is associated with higher successful cannulation. Methods We conducted a patient-level pooled analysis using data from two randomized-controlled trials (RCT) on DRA. All patients with available data on distal radial artery palpation and cannulation’s success were included in our analysis. Results A total of 435 patients were included in our analysis; 84 and 351 from the two studies, respectively. Demographic characteristics, pharmacotherapy details and procedural indications did not differ between the two groups (palpable versus non – palpable DRA), except BMI, which was significantly increased in non – palpable DRA group (27.3 versus 28.3 kg/m2, p=0.034). A palpable DRA was found in 313 (72%) patients. Successful cannulation did not significantly differ between the patients with a palpable and a non-palpable DRA (81.5% versus 80.3%, p=0.78) Furthermore, a multivariable analysis excluded any interactions with demographic characteristics, pharmacotherapy details and indications of procedure. Conclusions Our analysis showed that a non-palpable distal radial artery is not associated with lower cannulation success rates. Accordingly, the palpation of the DRA may not be required for achieving better cannulation results. As these findings have been obtained among experienced operators, further research is required to validate the generalizability of our results.