학술논문
International Hand Function Study Following Distal Radial Access: The RATATOUILLE Study.
Document Type
Academic Journal
Author
Sgueglia GA; Division of Cardiology, Sant'Eugenio Hospital, Rome, Italy. Electronic address: g.a.sgueglia@gmail.com.; Hassan A; Cardiology Department, St. Jansdal Hospital, Harderwijk, the Netherlands; Hartdokters, Amsterdam, the Netherlands.; Harb S; University Heart Center, Medical University of Graz, Graz, Austria.; Ford TJ; Gosford Hospital, Gosford, New South Wales, Australia.; Koliastasis L; Cardiology Department, Athens Naval Hospital, Athens, Greece.; Milkas A; Cardiology Department, Athens Naval Hospital, Athens, Greece.; Zappi DM; Hospital Dona Helena, Joinville, Brazil.; Navarro Lecaro A; QRA Medicina Especializada, Universidad San Francisco, Quito, Ecuador.; Ionescu E; Clínica Cardiovascular del Caribe, Monteria, Colombia.; Rankin S; Golden Jubilee National Hospital, Glasgow, United Kingdom.; Said CF; Gosford Hospital, Gosford, New South Wales, Australia.; Kuiper B; Independent Researcher, Bussum, the Netherlands.; Kiemeneij F; University of Amsterdam, Amsterdam, the Netherlands.
Source
Publisher: Elsevier Country of Publication: United States NLM ID: 101467004 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1876-7605 (Electronic) Linking ISSN: 19368798 NLM ISO Abbreviation: JACC Cardiovasc Interv Subsets: MEDLINE
Subject
Language
English
Abstract
Background: Distal radial access (DRA) has been proposed to improve procedure ergonomics and favor radial artery patency. Although promising data, nothing is known on evolving hand function after DRA.
Objectives: This study sought to comprehensively evaluate hand function in patients undergoing DRA.
Methods: Real-world patients undergoing DRA undertook a thorough multimodality assessment of hand function implementing multidomain questionnaires (Disabilities of the Arm, Shoulder and Hand and Levine-Katz), and motor (pinch grip test) and sensory (Semmes-Weinstein monofilaments test) examinations of both hands. All assessments were performed at preprocedural baseline and planned at 1-, 6-, and 12-month follow-up (FU). Adverse clinical and procedural events were documented too.
Results: Data of 313 patients (220 men, age 66 ± 10 years) from 9 international centers were analyzed. The Disabilities of the Arm, Shoulder and Hand and the Levine-Katz scores slightly improved from baseline to FU (P = 0.008 and P = 0.029, respectively). Pinch strength mildly improved from baseline to FU (P < 0.001 for both the left and right hands). Similarly, touch pressure threshold appeared to faintly improve in both the left and right hands (P < 0.012 for all the sites). For both motor and sensory function tests, comparable findings were found for the DRA hand and the contralateral one, with no significant differences between them. Repeated assessment of all tests over all FU time points similarly showed lack of worsening hand function. Access-related adverse events included 19 harmless bleedings and 3 forearm radial artery and 3 distal radial artery occlusions. None affected hand function at FU.
Conclusions: In a systematic multidimensional assessment, DRA was not associated with hand function impairment. Moreover, DRA emerges as a safe alternative vascular access.
Competing Interests: Funding Support and Author Disclosures Dr Sgueglia has served as a consultant for Terumo Europe, outside of the submitted work. Dr Kiemeneij has served as a consultant for Merit Medical Systems. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
(Copyright © 2022 American College of Cardiology Foundation. All rights reserved.)
Objectives: This study sought to comprehensively evaluate hand function in patients undergoing DRA.
Methods: Real-world patients undergoing DRA undertook a thorough multimodality assessment of hand function implementing multidomain questionnaires (Disabilities of the Arm, Shoulder and Hand and Levine-Katz), and motor (pinch grip test) and sensory (Semmes-Weinstein monofilaments test) examinations of both hands. All assessments were performed at preprocedural baseline and planned at 1-, 6-, and 12-month follow-up (FU). Adverse clinical and procedural events were documented too.
Results: Data of 313 patients (220 men, age 66 ± 10 years) from 9 international centers were analyzed. The Disabilities of the Arm, Shoulder and Hand and the Levine-Katz scores slightly improved from baseline to FU (P = 0.008 and P = 0.029, respectively). Pinch strength mildly improved from baseline to FU (P < 0.001 for both the left and right hands). Similarly, touch pressure threshold appeared to faintly improve in both the left and right hands (P < 0.012 for all the sites). For both motor and sensory function tests, comparable findings were found for the DRA hand and the contralateral one, with no significant differences between them. Repeated assessment of all tests over all FU time points similarly showed lack of worsening hand function. Access-related adverse events included 19 harmless bleedings and 3 forearm radial artery and 3 distal radial artery occlusions. None affected hand function at FU.
Conclusions: In a systematic multidimensional assessment, DRA was not associated with hand function impairment. Moreover, DRA emerges as a safe alternative vascular access.
Competing Interests: Funding Support and Author Disclosures Dr Sgueglia has served as a consultant for Terumo Europe, outside of the submitted work. Dr Kiemeneij has served as a consultant for Merit Medical Systems. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.
(Copyright © 2022 American College of Cardiology Foundation. All rights reserved.)