Recently, coronary angiography (CAG) and percutaneous coronary intervention (PCI) via the distal radial access (DRA), are gaining attention owing to fewer complications. Despite the advantages of the DRA, there is difficulty to initiate this new vascular approach. The data from 1000 patients who underwent CAG and PCI via the DRA by a single experienced radial operator were retrospectively analyzed. The primary outcome was the success rate of the DRA per 100 cases. Moreover, the predictors of the failed DRA were analyzed. Overall, 952 (95.2%) of the total 1,000 patients underwent a successful DRA. After experiencing 200 cases, the DRA success rate was well maintained at > 94%, and there was no difference in success rate per 100 cases (P_trend = 0.216). The predictors of failure were female sex [odds ratio (OR) 1.84, 95% confidence interval (CI) 1.01–3.39, P = 0.049] and systolic blood pressure (SBP) of < 120 mmHg (OR 1.87, 95% CI 1.04–3.36, P = 0.036). For achieving a stable DRA with the success rate of > 94%, 200 procedures would be needed. Moreover, this new approach could fail in women and patients with low SBP.

Trial registration: https://cris.nih.go.kr/cris/index/index.do (Unique identifier: KCT0005349).

最近，冠状动脉造影 (CAG) 和经皮冠状动脉介入术 (PCI) 通过远端桡动脉入路 (DRA)，由于并发症较少而受到关注。尽管 DRA 具有优势，但启动这种新的血管入路仍存在困难。回顾性分析了 1000 名由一位经验丰富的桡骨手术师通过 DRA 接受 CAG 和 PCI 的患者的数据。主要结果是每 100 例 DRA 的成功率。此外，还分析了 DRA 失败的预测因素。总体而言，1,000 名患者中有 952 名 (95.2%) 接受了成功的 DRA。经历200案件后，DRA成功率以及维持在> 94％，并有在每100案件成功率（无差异P_趋势 = 0.216）。失败的预测因素是女性 [优势比 (OR) 1.84，95% 置信区间 (CI) 1.01–3.39，P  = 0.049] 和收缩压 (SBP) < 120 mmHg（OR 1.87，95% CI 1.04– 3.36，P  = 0.036）。为了获得成功率 > 94% 的稳定 DRA，需要 200 次程序。此外，这种新方法在女性和 SBP 低的患者中可能会失败。

试用注册：https://cris.nih.go.kr/cris/index/index.do（唯一标识符：KCT0005349）。