# The safety and efficacy of non-emergent percutaneous coronary intervention via distal radial artery access in patients with acute coronary syndrome

## TL;DR

This study found that using a specific wrist artery access method during heart procedures reduces artery blockage and shortens recovery time.

## Contribution

The study demonstrates that distal transradial access reduces radial artery occlusion and hemostasis time in coronary interventions.

## Key findings

- Distal transradial access reduced radial artery occlusion at 24 hours by 92.5% compared to conventional access.
- Distal transradial access had shorter median compression hemostasis time by 74 minutes.
- No significant differences in bleeding, pain, or swelling between the two access methods.

## Abstract

The objective of this study was to evaluate the efficacy and safety of distal transradial access (dTRA) for non-emergent percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS).

This single-center, randomized controlled study was conducted in the Department of Cardiology at Inner Mongolia Medical University Affiliated Hospital between January and July 2025. Patients with ACS who met the inclusion criteria were assigned to the distal transradial access (dTRA) group or the conventional transradial access (TRA) group at a 1:1 ratio using a random number table method. Clinical baseline data and operation data were collected. Radial artery Doppler ultrasound was performed 24 h and 30 days after PCI to detect radial artery occlusion (RAO).

A total of 106 patients were included in the study, with no significant differences in clinical baseline data and operation data between the two groups. The incidence of RAO at 24 h after PCI in the dTRA group was significantly lower than that in the TRA group (1.9% vs. 15.1%, P = 0.037). However, this big difference was not significant at 30 days (0% vs. 5.7%, P = 0.241). The TRA group had a longer median compression hemostasis time (274 min vs. 200 min, P < 0.001). The median number of punctures, puncture time, and contrast agent dosage between the two groups were similar. The crossover rate in the dTRA and TRA groups was 7.5% and 5.7%, respectively. The incidences of forearm pain, bleeding, and swelling at the puncture site during and after PCI between the two groups were also similar. Logistic regression analysis identified dTRA (OR: 0.075; 95% CI: 0.008–0.723; P = 0.025) as an independent protective factor against RAO at 24 h, reducing the risk of the outcome by 92.5%.

For ACS patients undergoing non-emergent PCI, dTRA is a safe and effective approach. dTRA significantly reduced the incidence of RAO at 24 h after PCI and had a shorter hemostasis time, without affecting the interventional procedure.