Distal Transradial Access: a Safe and Feasible Approach for Coronary Catheterization in Cases of Total Radial Artery Occlusion

Radial artery occlusion (RAO) is still a major complication of coronary catheterization (CC) via transradial access (TRA). Recently, coronary angiography (CAG) and percutaneous coronary intervention (PCI) through distal transradial access (dTRA) have been proven to be safe and feasible, but RAO recanalization and complete CC via dTRA have been rarely reported. Twenty-nine consecutive patients with RAO were enrolled in the present study. RAO was first confirmed by ultrasonography and after puncture of the distal radial artery (RA) in the anatomical snuffbox; cannula angiography was conducted to confirm total RAO. With the exception of two patients, we successfully recanalized the occluded RA in 27 patients. After RAO recanalization, subsequent CAG and PCI were successful, and no complications occurred. RAO recanalization and complete coronary catheterization via dTRA are safe and feasible.