Transradial approach (TRA) is widely accepted and recommended as the standard approach for coronary angiography and any percutaneous coronary intervention (PCI) irrespective of clinical presentation. Trans-radial cardiac catheterization has been reported to be more beneficial compared to femoral approaches with easier hemostasis, better patient comfort, earlier ambulation, shorter hospital stay and less occurrence of short-term cardiac death, myocardial infarction and access-site complications. However, the use of TRA is not free of limitations, as the radial artery is prone to spasm and often presents  anatomical variation including severe tortuosity or loop formation, which can lead to obligatory crossover to other arterial access. 
Although previous studies have shown significantly lower rates of subclavian tortuosity and slightly shorter fluoroscopy times with left radial access compared to the right., left radial access is used less often, as it is not as ergonomic for the operator, especially for prolonged or complex PCI and in obese patients. Kiemeneji has recently proposed the radial artery cannulation in the anatomical snuffbox as an alternative radial artery cannulation. This new approach can overcome some drawbacks of standard radial artery approach in several aspects. Since the first publication in May 2017, several studies reported the safety and feasibility of the distal radial approach (DRA).
Coronary bifurcation lesions are involved in 15-20% of all PCI and remain one of the most complex and challenging lesions in terms of procedural success rate as well as long-term cardiac event. (9) However, there is a paucity of data regarding the feasibility of the DRA for the bifurcation PCI. This study sought to investigate the efficacy and safety of the distal radial approach in PCI for bifurcation lesion.

Cohort/Group Label

Patients underwent bifurcation PCI via left distal radial artery

Cohort/Group Description

We performed a single center, retrospective cohort study of patients who underwent PCI for bifurcation lesions via left DRA. From the medical records of 1,041 consecutive patients with Snuffbox approach in Chonnam National University Hospital (Dec 2017 to Dec 2019), we identified 446 patients with successfully treated the coronary artery disease. Among them, we enrolled 106 patients who were treated with bifurcation PCI via left DRA

We will evaluate the success rate of PCI, cross-over rate of the puncture site for pci, access-site complications including major bleeding requiring surgery or transfusion, hematoma, distal and forearm radial artery occlusion, and 30-day mortality.

Not collect nor Archive

1,041 consecutive patients in the Snuffbox registry of Chonnam National University Hospital (Dec 2017 to Dec 2019)

We performed a single center, retrospective cohort study of patients who underwent PCI for bifurcation lesions via left DRA.
From the medical records of 1,041 consecutive patients in the Snuffbox database of Chonnam National University Hospital (Dec 2017 to Dec 2019), we identified 446 patients with successfully treated the coronary artery disease. Among them, we enrolled 106 patients who were treated with bifurcation PCI via left DRA.

Gender

Age

Description

patients in the Snuffbox registry of Chonnam National University Hospital (Dec 2017 to Dec 2019)

no specific exclusion criteria

Success rate of percutaneous coronary intervention

just after procedure

Cross over rate of puncture site

just after procedure

30day mortality

one month after index procedure

radial artery occlusion

one month after index procedure

major bleeding requiring admission or surgery

one month after index procedure

access-site complication

one month after index procedure