ORIGINAL RESEARCH article
Front. Cardiovasc. Med.
Sec. Coronary Artery Disease
The safety and efficacy of not-emergent percutaneous coronary intervention via distal radial artery access in patients with acute coronary syndrome
Provisionally accepted
- Inner Mongolia Medical University Affiliated Hospital, Hohhot, China
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Objective To explore the efficacy and safety of distal transradial access (dTRA) for not-emergentelective percutaneous coronary intervention (PCI) in patients with acute coronary syndrome (ACS). Methods This was a single center randomized controlled study conducted in the department of cardiology, Inner Mongolia Medical University Affiliated Hospital, from January to July 2025. Patients with ACS who met the inclusion criteria were assigned to the distal transradial access (dTRA) group or the conventional transradial access (TRA) group at a 1:1 ratio using a random number table method. Clinical baseline data and opration data were collected. Radial artery doppler ultrasound was performed 24 hours and 30 days after PCI to detect radial artery occlusion (RAO). Results A total of 106 patients was included, with no significant differences in clinical baseline data and oprationoperation data between the two groups. The incidence of RAO at 24 hours after PCI in the dTRA group was significantly lower than that in the TRA group (1.9% vs. 15.1%, P=0.037), while this big difference was gone at 30 days (0 vs. 5.97%, P=0.248241). TRA group had a longer median compression hemostasis time (274min vs. 200min, P < 0.001). The median number of punctures, puncture time, and contrast agent dosage, and compression hemostasis time between the two groups were similar. The crossover rate in dTRA and TRA group was 7.5% and 5.7% separately. The incidences of forearm pain, bleeding and swelling at the puncture site during and after PCI between the two groups were also similar. Logistic regression analysis identified dTRA (OR: 0.075; 95% CI: 0.008 to 0.723; P = 0.025) as independent protective factor against RAO at 24h, reducing the risk of the outcome by 92.5%. Conclusions For ACS patients undergoing not-emergent PCI, dTRA is a safe and effective approach which can significantly reduce the incidence of RAO at 24 hours after PCI and had a shorter hemostasis time, without affecting the interventional procedure.
Keywords: distal radial artery access, Acute Coronary Syndrome, Percutaneous Coronary Intervention, Radial artery occlusion, Transradial access (TRA)
Received: 16 Sep 2025; Accepted: 26 Nov 2025.
Copyright: © 2025 Niu, Gao, Ren, Han, Jing, Gao, Bao and Guan. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Hong Guan
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