Distal Versus Proximal Radial Artery Access for Cardiac Catheterization and Intervention: Design and Rationale of the DIPRA Trial

Background: Radial artery (RA) catheterization is the access of choice over femoral artery access for most inter-ventional vascular procedures given its safety and faster patient recovery. There has been growing interest in distal radial artery (dRA) access as an alternative to the conventional proximal radial artery (pRA) access. Preserving the RA is important which serves asa potential conduit for future coronary artery bypass surgery, dialysis conduit or preserve the artery for future cardiovascular procedures. The dRA runs in close proximity to the radial nerve, which raises the concern of potential detrimental effects on hand function. Study design: The Distal versus Proximal Radial Artery Access for cardiac catheterization and intervention (DIPRA) trial isa prospective, randomized, parallel-controlled, open-label, single center study evaluating the out-comes of hand function and effectiveness of dRA compared to pRA access in patients undergoing cardiac cathe-terization. The eligible subjects will be randomized to dRA and pRA access ina (1:1) fashion. The primary end point is an evaluation of hand function at one and twelve months follow-up. Secondary end points include rates of access site hematoma, access site bleeding, other vascular access complications, arterial access success rate, and RA occlusion at one and twelve months follow up. Conclusion: Effects of dRA on hand function remains unknown and it's use questionable in the presence of a widely accepted pRA. DIPRA trial is designed to determine the safety and effectiveness of dRA for diagnostic and interventional cardiovascular procedures compared to the standard of care pRA. (C) 2021 Elsevier Inc. All rights reserved.