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. 2025 Jan 13;4(2):101565.
doi: 10.1016/j.jacadv.2024.101565. eCollection 2025 Feb.

Impact of Anthropometric Measures on Distal vs Conventional Radial Access for Percutaneous Coronary Procedures

Gregory A Sgueglia  1 , Adel Aminian  2 , Marcus Wiemer  3 , Joëlle Kefer  4 , Gabriele L Gasparini  5 , Zoltan Ruzsa  6   7 , Maarten A H van Leeuwen  8 , Claudiu Ungureanu  9 , Gregor Leibundgut  10 , Bert Vandeloo  11 , Sasko Kedev  12 , Ivo Bernat  13 , Karim Ratib  14 , Juan F Iglesias  15 , Elias Al Hage  2 , Shigeru Saito  16
Affiliations

Impact of Anthropometric Measures on Distal vs Conventional Radial Access for Percutaneous Coronary Procedures

Gregory A Sgueglia et al. JACC Adv. .

Abstract

Background: Results from the Distal vs Conventional Radial Access (DISCO RADIAL) trial confirmed distal radial access (DRA) as a valid alternative to conventional transradial access, with equally low rates of radial artery occlusion (RAO), yet higher crossovers but shorter hemostasis.

Objectives: The purpose of the study was to investigate whether patient anthropometric measures influence the effect of randomized access on key secondary outcomes.

Methods: DISCO RADIAL was an international, multicenter, randomized controlled trial in which patients with indications for percutaneous coronary procedure using a 6-F Slender sheath were randomized to DRA (n = 650) or transradial access (n = 657) implementing best practices to reduce RAO. The primary endpoint of the trial was incidence of forearm RAO, which was extremely uncommon. Secondary endpoints, including sheath insertion time, radial artery spasm, crossover (failure to obtain access through assigned access site), hemostasis time, and access site complications, were the focus of the current analysis. Regression models (linear for continuous and logistic for binary outcomes) were used to determine whether anthropometric measures (weight, height, body mass index, and body surface area) influenced the effect of randomized access on outcomes.

Results: Across tertiles of weight, height, body mass index, and body surface area, both before and after adjustment for sex and age, the main effect of vascular access on radial artery spasm, crossover, hemostasis time, and access site complications remained, with no significant interaction effect.

Conclusions: The results of this exploratory analysis are consistent with the main findings of the trial and support the use of DRA in all patients, regardless of anthropometric measures.

Keywords: body mass index; body surface area; distal radial access; height; transradial access; weight.

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Conflict of interest statement

The trial was sponsored and funded by Terumo Europe. Drs Sgueglia and Leibundgut have received consulting and lecture fees from Terumo and Cordis outside of the submitted work. Drs Aminian and Ratib have received consulting and lecture fees from Terumo. Dr Iglesias has received an unrestricted research grant to the institution from Terumo, outside of the submitted work; is a consultant for and has received personal fees from Terumo, outside of the submitted work; has received research grants to the institution from Abbott Vascular, AstraZeneca, Biosensors, Biotronik, Concept Medical, and Philips Volcano; and has received personal fees from AstraZeneca, Biotronik, Bristol Myers Squibb/Pfizer, Cardinal Health, Medtronic, Novartis, and Philips Volcano, outside the submitted work. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

Figures

None
Graphical abstract
Figure 1
Figure 1
Flow Chart of the Study DRA = distal radial access; TRA = transradial access.
Figure 2
Figure 2
Patients Study Groups Patients were divided into 3 groups based on tertiles of body weight, height, body mass index (BMI), and body surface area (BSA).
Figure 3
Figure 3
Effects of Randomization to Distal Radial Access vs Conventional Transradial Access on Radial Artery Spasm Across Tertiles of Anthropometric Measures No interaction was found between the main effect of vascular access on radial artery spasm and body weight, height, BMI, and BSA. Results are adjusted for sex and age. BMI = body mass index; BSA = body surface area; DRA = distal radial access; TRA = transradial access.
Figure 4
Figure 4
Effects of Randomization to Distal Radial Access vs Conventional Transradial Access on Access Site Crossover Across Tertiles of Anthropometric Measures No interaction was found between the main effect of vascular access on access site crossover and body weight, height, BMI, and BSA. Results are adjusted for sex and age. Abbreviations as in Figure 3.
Figure 5
Figure 5
Effects of Randomization to Distal Radial Access vs Conventional Transradial Access on Sheath Insertion Time Across Tertiles of Anthropometric Measures No interaction was found between the main effect of vascular access on sheath insertion time and body weight, height, BMI, and BSA. Results are adjusted for sex and age. Treatment effects for sheath insertion time (minutes) are difference in least squares mean Log(time + 1). Abbreviations as in Figure 3.
Central Illustration
Central Illustration
Impact of Anthropometric Measures on Distal vs Conventional Radial Access for Percutaneous Coronary Procedures In the DISCO RADIAL international multicenter randomized controlled trial patients with indications for percutaneous coronary procedure using 6-F Glidesheath Slender (Terumo) introducer sheath were randomized to distal radial access or conventional transradial access with systematic implementation of best practices to reduce radial artery occlusion (indicated by ∗). Of the study population, 1,303 patients were eligible for this subanalysis. Patients were divided into tertiles of relevant anthropometric measures and regression analysis was performed to assess whether anthropometric measures impacted the effect of randomized access on key secondary outcomes of the trial. No interaction was found between the main effect of vascular access on access site-related complications and hemostasis time, and body weight, height, BMI, and BSA. Results are adjusted for sex and age. Treatment effects for hemostasis time (minutes) are difference in least squares mean Log(time + 1). Abbreviations as in Figure 3.
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References

    1. Neumann F.J., Sousa-Uva M., Ahlsson A., et al. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J. 2019;40:87–165. - PubMed
    1. Lawton J.S., Tamis-Holland J.E., Bangalore S., et al. 2021 ACC/AHA/SCAI guideline for coronary artery revascularization: a report of the American college of cardiology/American heart association joint committee on clinical practice guidelines. J Am Coll Cardiol. 2022;79:e21–e129. - PubMed
    1. Ferrante G., Rao S.V., Juni P., et al. Radial versus femoral access for coronary interventions across the entire spectrum of patients with coronary artery disease: a meta-analysis of randomized trials. JACC Cardiovasc Interv. 2016;9:1419–1434. - PubMed
    1. Sgueglia G.A., Di Giorgio A., Gaspardone A., Babunashvili A. Anatomic basis and physiological rationale of distal radial artery access for percutaneous coronary and endovascular procedures. JACC Cardiovasc Interv. 2018;11:2113–2119. - PubMed
    1. Kiemeneij F. Left distal transradial access in the anatomical snuffbox for coronary angiography (ldTRA) and interventions (ldTRI) EuroIntervention. 2017;13:851–857. - PubMed

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