Key result
Distal radial artery access achieves a ~97% procedural success rate without crossover during coronary procedures.
Why the study?
Distal radial artery access has emerged as an alternative vascular access for coronary angiography and PCI, but real-world data regarding its procedural feasibility and outcomes remain limited.
Does distal radial artery access achieve high procedural completion without crossover and low complication rates in an all-comer cohort of patients (predominantly with acute coronary syndrome) undergoing coronary angiography and/or percutaneous coronary intervention?
Observational (n=835)
No
Does distal radial artery access achieve high procedural completion without crossover and low complication rates in an all-comer cohort of patients (predominantly with acute coronary syndrome) undergoing coronary angiography and/or percutaneous coronary intervention?
Distal radial artery access demonstrated a 97.1% procedural success rate without crossover and a 0.5% clinically apparent complication rate in a real-world Indonesian cohort predominantly presenting with acute coronary syndrome.
Answers are grounded in this paper and cite their sources.
Supports distal radial access feasibility in ACS; leaves open need for RCTs versus proximal radial access.
Background: Distal Radial Artery Access (DRA) has emerged as an alternative vascular access for Coronary Angiography (CGA) and Percutaneous Coronary Intervention (PCI). However, real-world data regarding its procedural feasibility and outcomes remain limited. This study aimed to evaluate the feasibility and procedural outcomes of distal radial artery access in patients undergoing CGA and/or PCI. Methods: We conducted a single-center observational registry including consecutive patients undergoing CGA or PCI with an initial attempt at DRA access. The primary feasibility endpoint was successful completion of the procedure via DRA without crossover to an alternative vascular access site. Results: A total of 835 patients were included in the analysis, representing an all-comer cohort including both Acute Coronary Syndrome (ACS) and Chronic Coronary Syndrome (CCS) presentations. The clinical indications included Non-ST-segment Elevation Myocardial Infarction (NSTEMI) in 326 patients (39%), Unstable Angina Pectoris (UAP) in 292 patients (35%), ST-segment Elevation Myocardial Infarction (STEMI) in 167 patients (20%), and stable coronary artery disease in 50 patients (6%). The primary feasibility endpoint, successful completion of the procedure via DRA without crossover, was achieved in 811 patients (97.1%). Crossover to an alternative access site occurred in 24 patients (2.9%), including contralateral proximal radial access in 13 patients (54.2%), femoral access in 10 patients (41.7%), and ipsilateral proximal radial access in 1 patient (4.2%). Conclusions: DRA access demonstrated high procedural feasibility for CGA and PCI in a real-world cohort including both acute and CCS presentations.
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Andjari et al. (2026) conducted an observational in Acute Coronary Syndrome and Chronic Coronary Syndrome (n=835). Distal Radial Artery Access (DRA) was evaluated on Successful completion of the procedure via distal radial artery access without crossover to an alternative vascular access site.
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