Distal Versus Conventional Transradial Artery Access for Coronary Catheterization in Patients With STEMI (DR-STEMI)

University Hospital of Patras

Status: Enrolling

Conditions: Coronary Artery Disease; Transradial Artery; ST Elevation Myocardial Infarction; Percutaneous Coronary Intervention; Coronary Catheterization; Distal Transradial Artery; Primary PCI

Treatments: Procedure: Coronary angiography +/- percutaneous coronary intervention

Study type: Interventional

Funder types: Other

Identifiers

NCT05605288

26150/30.09.22

Details and patient eligibility

About

Recently, a novel distal transradial, through anatomical snuffbox, approach has been proposed for undertaking percutaneous coronary angiography and interventions. The existing literature has evaluated distal transradial access (dTRA) as a feasible and safe approach, with faster hemostasis, lower rates of periprocedural complications and reduced incidence of radial artery occlusion (RAO). Aim of the present study is to compare dTRA versus conventional TRA access in patients with STEMI undergoing coronary angiography and interventions regarding peri- and post-procedural characteristics.

Full description

Gaining vascular access is the first, mandatory step for undertaking percutaneous coronary angiography and interventions. The recent guidelines, published by European Society of Cardiology (ESC), American College of Cardiology (ACC), American Heart Association (AHA) and Society for Cardiovascular Angiography and Interventions (SCAI), propose TRA as the gold standard for acute coronary syndromes (ACS), chronic coronary syndrome (CCS) percutaneous coronary interventions (PCI). Recently, a novel distal transradial, through anatomical snuffbox, approach has been proposed. The existing literature has evaluated distal transradial access (dTRA) as a feasible and safe approach, with faster hemostasis, lower rates of periprocedural complications and reduced incidence of radial artery occlusion (RAO). Mutual point of all the previous RCTs is that excluded patients suffering from ST-elevation Myocardial Infraction (STEMI). Aim of the present study is to compare dTRA versus conventional TRA access in patients with STEMI undergoing coronary angiography and interventions regarding peri- and post-procedural characteristics.

Enrollment: 554 estimated patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Age > 18 years old
• Indication: ST-Elevation Myocardial Infraction

Exclusion criteria

• Non-palpable radial artery
• Previous CABG
• Anatomical restrictions for forearm approach
• Hemodynamic instability
• Previous radial artery catheterization from the same arm during the last 30-days

Trial design

Primary purpose: Treatment

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: Single Blind

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554 participants in 2 patient groups

Distal transradial artery access

Experimental group

Description:

Vascular access after cannulation of distal transradial artery through anatomical snuffbox for coronary angiography and interventions

Treatment:

Procedure: Coronary angiography +/- percutaneous coronary intervention

Conventional transradial artery access

Active Comparator group

Description:

Vascular access after puncturing on the conventional transradial artery for performing coronary angiography and interventions

Treatment:

Procedure: Coronary angiography +/- percutaneous coronary intervention