DISCO Radial: DIStal Versus COventional Radial Access for Coronary Angiography and Intervention

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Recently, a new approach for arterial access has been introduced using the distal transradial artery approach (dTRA), which is located at the snuffbox, around the thumb at the dorsal hand.

The distal radial approach is being recommended for the following reasons:

• May reduce radial artery occlusion (RAO)^1-4
• Radiation exposure could decrease
  • With the conventional transradial approach potentially there is an elevated fluoroscopy-related radiation exposure for operators vs the transfemoral approach¹
• May reduce the rate of complications, (including radial artery spasm)¹
• Ergonomic positioning may improve
  • The transradial approach can require awkward positioning of operator relative to patient if left-sided access is needed whilst the operator is seated on patient's right¹

Data from registries and case series are providing insights into the safety and effectiveness of dTRA, but further clinical evidence from large randomized trials will be instrumental to establish the benefits and limitations of this access method and potentially have an important clinical impact for radial operators.

The DISCO RADIAL trial is the first large international randomized trial investigating the benefits of dTRA vs conventional TRA.

DISCO RADIAL is a prospective, global, open label, multi-centre randomized controlled trial with plan to include approximately 1,300 patients across 14 sites in 10 countries on who transradial coronary angiography and/or intervention is performed.

The trial compares the novel distal radial access with conventional radial access approach, in terms of radial occlusion rates (RAO) at discharge.

Clinicaltrials.gov. NCT04171570. Available at: https://clinicaltrials.gov/ct2/show/NCT04171570; Terumo data on file.