Distal versus conventional radial access for coronary angiography and intervention: Design and rationale of DISCO RADIAL study
Language English Country United States Media print-electronic
Document type Journal Article, Multicenter Study, Randomized Controlled Trial, Research Support, Non-U.S. Gov't
PubMed
34666014
DOI
10.1016/j.ahj.2021.10.180
PII: S0002-8703(21)00432-4
Knihovny.cz E-resources
- Keywords
- Distal radial access, Radial artery occlusion, Transradial access, Transradial approach,
- MeSH
- Radial Artery MeSH
- Arterial Occlusive Diseases * MeSH
- Coronary Angiography methods MeSH
- Percutaneous Coronary Intervention * methods MeSH
- Humans MeSH
- Prospective Studies MeSH
- Treatment Outcome MeSH
- Check Tag
- Humans MeSH
- Publication type
- Journal Article MeSH
- Multicenter Study MeSH
- Research Support, Non-U.S. Gov't MeSH
- Randomized Controlled Trial MeSH
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.
Department of Cardiology Centre Hospitalier Universitaire de Charleroi Charleroi Belgium
Department of Cardiology Geneva University Hospital Geneva Switzerland
Department of Cardiology Isala Heart Center Zwolle the Netherlands
Department of Cardiology Jolimont Hospital La Louvière Belgium
Department of Cardiology Shonan Kamakura General Hospital Kanagawa Japan
Department of Cardiology Universitair Ziekenhuis Brussel Vrije Universiteit Brussel Brussels Belgium
Division of Cardiology Cliniques Universitaires Saint Luc Brussels Belgium
Division of Cardiology Sant'Eugenio Hospital Rome Italy
European Medical and Clinical Division Terumo Europe N 5 Leuven Belgium
Humanitas Clinical and Research Center IRCCS Rozzano Milan Italy
Interventional Cardiology Department University Clinic of Cardiology Skopje Macedonia
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