Decrease Artery Occlusion by Distal Radial Arterial Cannulation in ACS Patients

Study Overview
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Brief Summary
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The site of arterial access for coronary angiography and intervention has been the focus of research for decades as it is the source of major complications. Transradial access (TRA) reduces complications among patients undergoing percutaneous coronary procedures but is reported with the complication of radial artery occlusion (RAO) that limits the radial artery for future needs. Distal radial access (dTRA) has recently gained global popularity as an alternative access route for vascular procedures. Among the benefits of dTRA are the low risk of entry site bleeding complications, the low rate of radial artery occlusion, and improved patient and operator comfort. This study aims to reveal the feasibility and safety of dTRA and routine TRA procedures in acute coronary syndrome patients. The primary endpoints are forearm radical occlusion rate and major adverse cardiovascular events (MACEs) in the two groups, respectively. Investigators will also focus on puncture success in diagnostic and interventional cases, rate of One attempt success, access time, procedure time, crossover rate, contrast dose of patients, fluoroscopy time and dose, and healthcare cost of each group.

Official Title
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Decrease Artery Occlusion by Distal Radial Arterial Cannulation in ACS Patients

Conditions
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Acute Coronary Syndrome, Procedural Complication

Intervention / Treatment
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* Procedure: distal TRA group
* Procedure: conventional TRA group


Participation Criteria
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Eligibility Criteria
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Inclusion Criteria: presence of a pulse in the snuffbox Exclusion Criteria: Absence of pulse Ultrasound indication of arterial occlusion or severe calcification Severe forearm artery malformation Patients with severe liver and renal failure, or abnormal coagulation function Established cardiogenic shock History of previous coronary artery bypass grafting and radial artery use. Raynaud's disease in the medical history

Ages Eligible for Study
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Minimum Age: 18 Years
Maximum Age: 85 Years

Sexes Eligible for Study
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All

Accepts Healthy Volunteers
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No

Study Plan
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How is the study designed?
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Design Details

Primary Purpose: Treatment
Allocation: Non-Randomized
Intervention Model: Parallel Assignment
Masking: Single


Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| Experimental: dTRA group<br>Investigators perform percutaneous coronary intervention by dTRA | Procedure: distal TRA group<br>* dTRA for PCI procedure to ACS patients.<br>|
| Other: TRA group<br>Investigators perform percutaneous coronary intervention by conventional TRA | Procedure: conventional TRA group<br>* Conventional TRA for PCI procedure to ACS patients<br>|

What is the study measuring?
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Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Forearm radical occlusion | Doppler ultrasound to determine whether patients suffer forearm radial occlusion | during procedure | 
| MACEs | Major Adverse Cardiovascular Events, including cardiovascular death, myocardial infarction and heart failure. | during procedure | 

Secondary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Rate of One attempt success | Rate of One attempt success of 2 kinds of procedure | during procedure | 
| Access time | Access time of 2 kinds of procedure | during procedure | 
| Procedure time | Procedure time of 2 kinds of procedure | during procedure | 
| Crossover rate | Crossover rate of 2 kinds of procedure | during procedure | 
| Contrast dose | Contrast dose of 2 kinds of procedure | during procedure | 
| Fluoroscopy dose | Fluoroscopy dose of 2 kinds of procedure | during procedure | 
| hand hematoma | hand hematoma rate of 2 kinds of procedure | during procedure | 
| The total cost in hospitalization | Healthcare cost . | up to 2 years | 

 Terms related to the study
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Keywords Provided by Centre Hospitalier Valida
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Distal Radial Access, Radial Artery Occlusion, Major Adverse Cardiovascular Events