Feasibility and Safety of the Routine Distal Transradial Approach

distAl vs. coNventional Transradial Access for coRonary procEdures Study (ANTARES)

The distal transradial approach (dTRA) via the anatomical snuffbox is hypothesized to be more beneficial than the conventional transradial access (cTRA) in patients undergoing coronary procedures. This prospective single-center randomized trial was designed to investigate the safety, efficacy, and various ultrasound parameters of dTRA.

Transradial approach (TRA) has emerged in most countries as a default strategy in urgent and elective coronary procedures. The advantages of TRA compared to the transfemoral access encompass a reduction of mortality, complications, and cost as well as improvement of patient's comfort. The aim of the present study (ANTARES, distAl vs coNventional Transradial Access for coRonary procEdures Study) was to assess the feasibility, safety and various ultrasound parameters of dTRA in the anatomical snuffbox as the first-line strategy, in comparison with cTRA, in patients undergoing coronary angiography (CAG) and percutaneous coronary intervention (PCI). The study is a non-inferiority, randomized controlled trial. There are two arms: distal transradial access and conventional transradial approach.

400 patients were enrolled.

Inclusion Criteria:

• patients referred for CAG and/or PCI

Exclusion Criteria:

• ST-elevation myocardial infarction
• sudden cardiac arrest
• hemody-namic instability
• chronic kidney disease (stages 4-5)
• forearm artery occlusion
• previous unsuccessful ipsilateral TRA
• unfavorable RA diameter
• ultrasound unavailability