Distal Radial Access in Chronic Total Occlusion Percutaneous Coronary Intervention: Insights From the PROGRESS-CTO Registry

Ilias Nikolakopoulos, Taral Patel, Brian K. Jefferson, Abdul M. Sheikh, Wissam Jaber, Habib Samady, Jaikirshan J. Khatri, Robert W. Yeh, Hector Tamez, Michalis Koutouzis, Ioannis Tsiafoutis, Farouc A. Jaffer, Anthony H. Doing, Phil Dattilo, Barry F. Uretsky, Catalin Toma, Basem Elbarouni, Khaldoon Alaswad, James W. Choi, Nicholas J. LemboManish Parikh, Ajay J. Kirtane, Ziad A. Ali, Mohamed Omer, Evangelia Vemmou, Iosif Xenogiannis, Judit Karacsonyi, Bavana V. Rangan, Shuaib Abdullah, Subhash Banerjee, Santiago Garcia, M. Nicholas Burke, Emmanouil S. Brilakis, Dimitri Karmpaliotis

Research output: Contribution to journalArticlepeer-review

6 Scopus citations


BACKGROUND: The outcomes of distal radial access (dRA) in chronic total occlusion percutaneous coronary intervention (CTO-PCI) have received limited study. METHODS: We compared the clinical, angiographic, and procedural characteristics of 120 CTO-PCIs performed via dRA access with 2625 CTO-PCIs performed via proximal radial access (pRA) in a large, multicenter registry. RESULTS: The dRA group had lower mean PROGRESS-CTO score than the pRA group (1.0 ± 1 vs 1.2 ± 1, respectively; P=.05), while J-CTO score (2.4 ± 1.2 vs 2.3 ± 1.3; P=.43) and PROGRESS-CTO Complications score (2.8 ± 1.8 vs 2.6 ± 1.9; P=.16) were similar in the dRA vs pRA groups, respectively. Technical success was similar in the 2 groups (90% dRA vs 86% pRA; P=.14). Concomitant use of femoral access did not alter procedural success. The incidence of major periprocedural adverse cardiac events was similar in the 2 groups (0.8% dRA vs 2.4% pRA; P=.26), whereas the incidence of tamponade requiring pericardiocentesis was lower with dRA (0% dRA vs 4.69% pRA; P<.001), as was air kerma radiation dose (median, 1.7 Gy; interquartile range [IQR], 0.97-2.63 Gy in the dRA group vs median, 2.27 Gy; IQR, 1.2-3.9 Gy in the pRA group; P<.001). CONCLUSIONS: Use of dRA in CTO-PCI is associated with similar procedural success and risk of complications as compared with pRA.

Original languageEnglish (US)
Pages (from-to)E717-E722
JournalThe Journal of invasive cardiology
Issue number9
StatePublished - Sep 1 2021


  • coronary occlusion
  • percutaneous coronary intervention
  • radial artery

ASJC Scopus subject areas

  • General Medicine


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