en
Scientific article
Open access
English

Distal versus conventional radial access for coronary angiography and intervention: Design and rationale of DISCO RADIAL study

Published inThe American heart journal, vol. 244, p. 19-30
Publication date2022-02
First online date2021-10-16
Abstract

Background: Transradial access (TRA) has become the default access method for coronary diagnostic and interventional procedures. As compared to transfemoral access, TRA has been shown to be safer, cost-effective and more patient-friendly. Radial artery occlusion (RAO) represents the most frequent complication of TRA, and precludes future coronary procedures through the radial artery, the use of the radial artery as a conduit for coronary artery bypass grafting or as arteriovenous fistula for patients on hemodialysis. Recently, distal radial access (DRA) has emerged as a promising alternative to TRA, yielding potential for minimizing the risk of RAO. However, an international multicenter randomized comparison between DRA, and conventional TRA with respect to the rate of RAO is still lacking.

Trial design: DISCO RADIAL is a prospective, multicenter, open-label, randomized, controlled, superiority trial. A total of 1300 eligible patients will be randomly allocated to undergo coronary angiography and/or percutaneous coronary intervention (PCI) through DRA or TRA using the 6 Fr Glidesheath Slender sheath introducer. Extended experience with both TRA and DRA is required for operators' eligibility and optimal evidence-based best practice to reduce RAO systematically implemented by protocol. The primary endpoint is the incidence of forearm RAO assessed by vascular ultrasound at discharge. Several important secondary endpoints will also be assessed, including access-site cross-over, hemostasis time, and access-site related complications.

Summary: The DISCO RADIAL trial will provide the first large-scale multicenter randomized evidence comparing DRA to TRA in patients scheduled for coronary angiography or PCI with respect to the incidence of RAO at discharge.

eng
Keywords
  • Distal radial access
  • Radial artery occlusion
  • Transradial access
  • Transradial approach
Citation (ISO format)
AMINIAN, Adel et al. Distal versus conventional radial access for coronary angiography and intervention: Design and rationale of DISCO RADIAL study. In: The American heart journal, 2022, vol. 244, p. 19–30. doi: 10.1016/j.ahj.2021.10.180
Main files (1)
Article (Published version)
Identifiers
ISSN of the journal0002-8703
100views
46downloads

Technical informations

Creation02/21/2022 3:33:00 PM
First validation02/21/2022 3:33:00 PM
Update time03/16/2023 7:36:40 AM
Status update03/16/2023 7:36:38 AM
Last indexation02/12/2024 12:25:40 PM
All rights reserved by Archive ouverte UNIGE and the University of GenevaunigeBlack