Effectiveness of the Anatomical Snuff Box Approach for Coronary Angiography (COROTAB)

GCS Ramsay Santé pour l'Enseignement et la Recherche

Status: Completed

Conditions: Coronary Angiography

Treatments: Procedure: Coronary angiography

Study type: Interventional

Funder types: Other

Identifiers

NCT05725616

2022-A01928-35

Details and patient eligibility

About

The main objective of the study is to assess whether the distal radial arterial approach (snuff box or back of the hand) is not inferior to the radial arterial approach at the wrist, in the management of coronary angiography for diagnostic purposes

Full description

Coronary angiography is the reference examination for anatomical exploration coronary arteries to determine the presence or absence of a predominantly obstructive coronary disease.

Historically, the femoral approach was the most common approach used in interventional cardiology. The radial approach to the forearm presents multiple advantages over the femoral route, and it became the gold standard approach to coronary angiography and intervention percutaneous coronary. Although uncommon, vascular complications related to the radial pathway exist.

This is why a more distal radial approach, above the long tendon extensor of the thumb (at the level of the anatomical snuff box) or downstream (at the back of the hand) was suggested more than 10 years ago. This pathway is now an advantageous alternative to the radial approach of first intention, both for the patient and for the practitioner.

The two procedures are common today but few studies have been developed to compare the two approaches. Therefore, the main objective of the study is to assess whether the distal radial arterial approach (snuff box or back of the hand) is not inferior to the radial arterial approach at the wrist, in the management of coronary angiography for diagnostic purposes

Enrollment: 326 patients

Sex: All

Ages: 18+ years old

Volunteers: No Healthy Volunteers

Inclusion criteria

• Patient, male or female, aged 18 and over
• Patient having a diagnostic coronary angiography programmed by radial route.
• Patient with a radial pulse at the anatomical snuff box and at the wrist noticeable

Exclusion criteria

• Patient requiring emergency coronary angiography or having an acute coronary syndrome
• Patient with severe arteriopathy of the supra-aortic trunks
• Patient with a history of coronary bypass surgery
• Tall patients (>1.90m)
• Patient allergic to xylocaine
• Patient presenting a contraindication to the realization of a coronary angiography:

terminal IRC, pregnancy, severe sepsis....

Trial design

Primary purpose: Other

Allocation: Randomized

Interventional model: Parallel Assignment

Masking: None (Open label)

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326 participants in 2 patient groups

Snuff box puncture

Experimental group

Description:

Puncture of the radial artery at of the anatomical snuff box or on the back of the hand during coronary angiography

Treatment:

Procedure: Coronary angiography

Wrist puncture

Active Comparator group

Description:

Puncture of the radial artery at the level of the base of the wrist during coronary angiography

Treatment:

Procedure: Coronary angiography