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Anatomical sNuffbox for Coronary anGiography and IntervEntions (ANGIE)

U

University Hospital of Patras

Status

Completed

Conditions

Coronary Artery Disease
Vascular Access Complication

Treatments

Procedure: Coronary angiography +/- percutaneous coronary intervention

Study type

Interventional

Funder types

Other

Identifiers

NCT03986151
11994/6-5-2019

Details and patient eligibility

About

This randomized, single-center, prospective study seeks to compare the conventional radial approach with the recently described distal radial approach (anatomical snuffbox) concerning the patency of the radial artery in patients subjected to coronary angiography or percutaneous coronary intervention.

Full description

Transradial approach has become the standard approach for coronary angiography (CAG) and percutaneous coronary intervention (PCI). The current ESC/EACTS guidelines of myocardial revascularization support using radial approach (RA) rather than femoral approach (FA) if the operators are experts for RA. Recently, an alternative transradial access has been suggested at the anatomical snuffbox, with potential additional benefits including a reduction in radial artery occlusion rate (which allows reintervention through the same access site and potential use as a graft), a decrease in other local vascular complications, shorter hemostasis duration, patients' intra and post procedural comfort and shorter recovery time. However, the feasibility of PCI via snuffbox approach is still concerned due to the lack of data. Therefore, the aim of the study is to compare the two approaches concerning the patency of the radial artery ≥30 days after the intervention with Doppler in a randomized way. Due to the anastomosis of the distal radial artery with the superficial palmar arch, even in case of total radial artery occlusion within the anatomical snuffbox, the antegrade blood flow may be preserved and, therefore, decreased incidents of radial artery occlusion are expected in the right distal radial artery approach group. The mean diameter of radial artery at the anatomical snuffbox is 2.4 mm, whereas the mean diameter of the radial artery at the forearm is 2.7 mm, and this could potentially contribute to shorter hemostasis duration.

Enrollment

1,042 patients

Sex

All

Ages

18+ years old

Volunteers

No Healthy Volunteers

Inclusion criteria

  • Indication for coronary angiography
  • Informed consent

Exclusion criteria

  • Non palpable right radial artery
  • Prior complicated right transradial intervention (radial artery dissection, perforation, occlusion)
  • Prior CABG
  • STEMI
  • Hemodynamic instability
  • Anatomical restrictions (fistula, etc)

Trial design

Primary purpose

Prevention

Allocation

Randomized

Interventional model

Parallel Assignment

Masking

Single Blind

1,042 participants in 2 patient groups

Conventional radial access
Active Comparator group
Treatment:
Procedure: Coronary angiography +/- percutaneous coronary intervention
Distal radial access
Experimental group
Treatment:
Procedure: Coronary angiography +/- percutaneous coronary intervention

Trial contacts and locations

1

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Data sourced from clinicaltrials.gov

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