A Randomized Comparison of Radial Artery Intimal Hyperplasia Following Distal Versus Proximal Transradial Access for Coronary Angiography: PRESERVE RADIAL
Background Distal transradial access (dTRA) is an alternative to conventional forearm transradial access (fTRA) for coronary angiography (CAG). Differences in healing of the radial artery (RA) in the forearm have not been evaluated between these 2 access strategies. We sought to compare the mean dif...
| Main Authors: | , , , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2024-02-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.123.031504 |
| _version_ | 1797302237942251520 |
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| author | Behnam N. Tehrani Matthew W. Sherwood Abdulla A. Damluji Kelly C. Epps Hooman Bakhshi Lindsey Cilia Isuru Dassanayake Moemen Eltebaney Raghav Gattani Edward Howard David Kepplinger Araba Ofosu‐Somuah Wayne B. Batchelor |
| author_facet | Behnam N. Tehrani Matthew W. Sherwood Abdulla A. Damluji Kelly C. Epps Hooman Bakhshi Lindsey Cilia Isuru Dassanayake Moemen Eltebaney Raghav Gattani Edward Howard David Kepplinger Araba Ofosu‐Somuah Wayne B. Batchelor |
| author_sort | Behnam N. Tehrani |
| collection | DOAJ |
| description | Background Distal transradial access (dTRA) is an alternative to conventional forearm transradial access (fTRA) for coronary angiography (CAG). Differences in healing of the radial artery (RA) in the forearm have not been evaluated between these 2 access strategies. We sought to compare the mean difference in forearm RA intimal‐medial thickening (IMT) in patients randomized to dTRA versus fTRA. Methods and Results In this single‐center randomized clinical trial, 64 patients undergoing nonemergent CAG were randomized (1:1) to dTRA versus fTRA. Ultra–high‐resolution (55‐MHz) vascular ultrasound of the forearm and distal RA was performed pre‐CAG and at 90 days. The primary end point was the mean change in forearm RA IMT. Secondary end points included procedural characteristics, vascular injury, RA occlusion, and ipsilateral hand pain and function. Baseline demographics and clinical characteristics, mean forearm RA IMT, and procedural specifics were similar between the dTRA and fTRA cohorts. There was no difference in mean change in forearm RA IMT between the 2 cohorts (0.07 versus 0.07 mm; P=0.37). No RA occlusions or signs of major vascular injury were observed at 90 days. Ipsilateral hand pain and function (Borg pain scale score: 12 versus 11; P=0.24; Disabilities of the Arm, Shoulders, and Hand scale score: 6 versus 8; P=0.46) were comparable. Conclusions Following CAG, dTRA was associated with no differences in mean change of forearm RA IMT, hand pain, and function versus fTRA for CAG. Further investigation is warranted to elucidate mechanisms and predictors of RA healing and identify effective strategies to preserving RA integrity for repeated procedures. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT04801901. |
| first_indexed | 2024-03-07T23:33:52Z |
| format | Article |
| id | doaj.art-cd9df8b65d354c9583ae7bb401c5c16d |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-03-07T23:33:52Z |
| publishDate | 2024-02-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-cd9df8b65d354c9583ae7bb401c5c16d2024-02-20T11:24:52ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802024-02-0113410.1161/JAHA.123.031504A Randomized Comparison of Radial Artery Intimal Hyperplasia Following Distal Versus Proximal Transradial Access for Coronary Angiography: PRESERVE RADIALBehnam N. Tehrani0Matthew W. Sherwood1Abdulla A. Damluji2Kelly C. Epps3Hooman Bakhshi4Lindsey Cilia5Isuru Dassanayake6Moemen Eltebaney7Raghav Gattani8Edward Howard9David Kepplinger10Araba Ofosu‐Somuah11Wayne B. Batchelor12Inova Schar Heart and Vascular Falls Church VA USAInova Schar Heart and Vascular Falls Church VA USAInova Schar Heart and Vascular Falls Church VA USAInova Schar Heart and Vascular Falls Church VA USAInova Schar Heart and Vascular Falls Church VA USAInova Schar Heart and Vascular Falls Church VA USAGeorge Mason University Fairfax VA USAInova Schar Heart and Vascular Falls Church VA USAInova Schar Heart and Vascular Falls Church VA USAInova Schar Heart and Vascular Falls Church VA USAGeorge Mason University Fairfax VA USAInova Schar Heart and Vascular Falls Church VA USAInova Schar Heart and Vascular Falls Church VA USABackground Distal transradial access (dTRA) is an alternative to conventional forearm transradial access (fTRA) for coronary angiography (CAG). Differences in healing of the radial artery (RA) in the forearm have not been evaluated between these 2 access strategies. We sought to compare the mean difference in forearm RA intimal‐medial thickening (IMT) in patients randomized to dTRA versus fTRA. Methods and Results In this single‐center randomized clinical trial, 64 patients undergoing nonemergent CAG were randomized (1:1) to dTRA versus fTRA. Ultra–high‐resolution (55‐MHz) vascular ultrasound of the forearm and distal RA was performed pre‐CAG and at 90 days. The primary end point was the mean change in forearm RA IMT. Secondary end points included procedural characteristics, vascular injury, RA occlusion, and ipsilateral hand pain and function. Baseline demographics and clinical characteristics, mean forearm RA IMT, and procedural specifics were similar between the dTRA and fTRA cohorts. There was no difference in mean change in forearm RA IMT between the 2 cohorts (0.07 versus 0.07 mm; P=0.37). No RA occlusions or signs of major vascular injury were observed at 90 days. Ipsilateral hand pain and function (Borg pain scale score: 12 versus 11; P=0.24; Disabilities of the Arm, Shoulders, and Hand scale score: 6 versus 8; P=0.46) were comparable. Conclusions Following CAG, dTRA was associated with no differences in mean change of forearm RA IMT, hand pain, and function versus fTRA for CAG. Further investigation is warranted to elucidate mechanisms and predictors of RA healing and identify effective strategies to preserving RA integrity for repeated procedures. Registration URL: https://www.clinicaltrials.gov; Unique identifier: NCT04801901.https://www.ahajournals.org/doi/10.1161/JAHA.123.031504distal transradial accessintimal‐medial thickeningtransradial coronary angiographyvascular healing |
| spellingShingle | Behnam N. Tehrani Matthew W. Sherwood Abdulla A. Damluji Kelly C. Epps Hooman Bakhshi Lindsey Cilia Isuru Dassanayake Moemen Eltebaney Raghav Gattani Edward Howard David Kepplinger Araba Ofosu‐Somuah Wayne B. Batchelor A Randomized Comparison of Radial Artery Intimal Hyperplasia Following Distal Versus Proximal Transradial Access for Coronary Angiography: PRESERVE RADIAL Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease distal transradial access intimal‐medial thickening transradial coronary angiography vascular healing |
| title | A Randomized Comparison of Radial Artery Intimal Hyperplasia Following Distal Versus Proximal Transradial Access for Coronary Angiography: PRESERVE RADIAL |
| title_full | A Randomized Comparison of Radial Artery Intimal Hyperplasia Following Distal Versus Proximal Transradial Access for Coronary Angiography: PRESERVE RADIAL |
| title_fullStr | A Randomized Comparison of Radial Artery Intimal Hyperplasia Following Distal Versus Proximal Transradial Access for Coronary Angiography: PRESERVE RADIAL |
| title_full_unstemmed | A Randomized Comparison of Radial Artery Intimal Hyperplasia Following Distal Versus Proximal Transradial Access for Coronary Angiography: PRESERVE RADIAL |
| title_short | A Randomized Comparison of Radial Artery Intimal Hyperplasia Following Distal Versus Proximal Transradial Access for Coronary Angiography: PRESERVE RADIAL |
| title_sort | randomized comparison of radial artery intimal hyperplasia following distal versus proximal transradial access for coronary angiography preserve radial |
| topic | distal transradial access intimal‐medial thickening transradial coronary angiography vascular healing |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.123.031504 |
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