Decrease Artery Occlusion by Distal Radial Arterial Cannulation, Observational Study

Study Overview
=================
Brief Summary
-----------------
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. Investigators conduct this retrospected analysis to demonstrate the difference of the two procedure of Cannulation.

Official Title
-----------------
Decrease Artery Occlusion by Distal Radial Arterial Cannulation, Observational Study

Conditions
-----------------
Outcome, Fatal, Acute Coronary Syndrome, Procedural Complication

Intervention / Treatment
-----------------
* Procedure: Radial Artery Approach


Participation Criteria
=================
Eligibility Criteria
-----------------
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
-----------------
Minimum Age: 18 Years
Maximum Age: 85 Years

Sexes Eligible for Study
-----------------
All

Study Plan
=================
How is the study designed?
-----------------

Arms and Interventions

| Participant Group/Arm | Intervention/Treatment |
| --- | --- |
| dTRA group<br>Investigators perform percutaneous coronary intervention by dTRA for patients | Procedure: Radial Artery Approach<br>* dTRA or conventional TRA for radical artery approach<br>|
| TRA group<br>Investigators perform percutaneous coronary intervention by conventional TRA for patients | Procedure: Radial Artery Approach<br>* dTRA or conventional TRA for radical artery approach<br>|

What is the study measuring?
-----------------
Primary Outcome Measures

| Outcome Measure | Measure Description | Time Frame |
| --- | --- | --- |
| Forearm radical | Doppler ultrasound to determine whether patients suffer forearm radial occlusion | 2 years | 
| MACEs | Major Adverse Cardiovascular Events, including cardiovascular death, myocardial infarction and heart failure. | 2 years | 

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