Distal versus proximal transradial access for diagnostic cerebral angiography: A single-center experience.

BACKGROUND

To compare the safety and effectiveness of cerebral angiography via distal transradial access puncture (dTRA) versus proximal radial artery puncture (pTRA).

METHODS

A total of 494 patients undergoing cerebral angiography were randomly assigned to either the dTRA or pTRA groups in a 1:1 ratio. The study evaluated puncture success rates, puncture time, procedural fluoroscopy time, operation time, and the incidence of complications between the two groups.

RESULTS

The success rate for dTRA was 92.7 % (229/247), compared to 99.19 % (245/247) for pTRA. In cases where dTRA failed, switching to pTRA achieved a 100 % success rate (18/18). The average puncture time for dTRA was 6.61 ± 4.12 min (p = 0.021), compared to 5.74 ± 4.12 min for pTRA. Fluoroscopy time was 8.03 ± 3.50 min for dTRA and 8.18 ± 3.30 min for pTRA (p = 0.639). The procedural operation time was 17.33 ± 5.38 min for dTRA and 16.84 ± 5.11 min for pTRA (p = 0.32). The incidence of radial artery occlusion, hand edema, and subcutaneous hematoma was significantly lower in the dTRA group compared to the pTRA group.

CONCLUSIONS

Cerebral angiography via the dTRA approach is safe and effective, with a lower incidence of radial artery occlusion. Failure of dTRA does not preclude subsequent successful pTRA, making dTRA a viable option for cerebral angiography.