​distal Transradial Access (dTRA): A new approach that may further optimize Transradial Access (TRA)

Recently, a new approach for arterial access has been introduced using the distal transradial artery approach (dTRA), which is located at the snuffbox, around the thumb at the dorsal hand.

The distal radial approach is being recommended for the following reasons:

• May reduce radial artery occlusion (RAO)^1-4

• Radiation exposure could decrease

• With the conventional transradial approach potentially there is an elevated fluoroscopy-related radiation exposure for operators vs the transfemoral approach¹

• May reduce the rate of complications, (including radial artery spasm)¹

• Ergonomic positioning may improve

• The transradial approach can require awkward positioning of operator relative to patient if left-sided access is needed whilst the operator is seated on patient's right¹

Data from registries and case series are providing insights into the safety and effectiveness of dTRA, but further clinical evidence from large randomized trials will be instrumental to establish the benefits and limitations of this access method and potentially have an  important clinical impact for radial operators.

About the DISCO RADIAL trial

The DISCO RADIAL trial is the first large international randomized trial investigating the benefits of dTRA vs conventional TRA.

DISCO RADIAL is a prospective, global, open label, multi-centre randomized controlled trial with plan to include approximately 1,300 patients across 14 sites in 10 countries on who transradial coronary angiography and/or intervention is performed.

The trial compares the novel distal radial access with conventional radial access approach, in terms of radial occlusion rates (RAO) at discharge.

Clinicaltrials.gov. NCT04171570. Available at: https://clinicaltrials.gov/ct2/show/NCT04171570; Terumo data on file.

Learn more about DISCO RADIAL from the Primary Investigators

Dr. Adel Aminian, C.H.U. de Charleroi, Belgium 
Dr. Shigeru Saito, Shonan Kamakura General Hospital, Japan

Trial Design

~1,300 patients requiring transradial coronary angiography and/or intervention

​Inclusion criteria	​Exclusion criteria
​ ≥18 years of age   Undergoing diagnostic coronary angiography and/or PCI Suitable for both dTRA and conventional TRA using 6Fr Glidesheath Slender™	​ Medical condition that may cause noncompliance with the protocol and/or confound data interpretation Chronic hemodialysis ST-elevated myocardial infarction Chronic total occlusion lesions in coronary artery

The radial access device used: Glidesheath Slender™

​6Fr Glidesheath Slender™ is used in all patients to standardized access
​ Ultra-thin wall allowing 1Fr reduction in outer diameter Retains larger inner diameter Hydrophilic coating	​

DISCO RADIAL trial results

Results of the DISCO Radial trial are expected later in 2021.

 
References