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Transradial AccessNCT04801901

Distal Transradial Access for Percutaneous Coronary Intervention

A study testing dTRA and fTRA in people with Transradial Access and Coronary Angiography, run by Inova Health Care Services at 1 site in United States.

Completed

Finished. The study has ended and is not enrolling. Results may be posted on the official record.

Official record
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Trial summary

Prospective randomized non-blinded study to determine degree of vessel trauma and adverse remodeling of the proximal forearm radial artery following distal radial artery access (dTRA) for cardiac catheterization compared to standard forearm transradial access (fTRA). Read more about this study

Who is it for?
Ages 18 years and olderHealthy volunteers can take part
What is being tested?
dTRA and fTRA
Type of treatment
Surgery or procedure
Could I receive a placebo?
No, everyone receives an active treatment
How many people
64 participants
Where
1 siteUnited States
Study dates
1 Oct 2021to 29 Jul 2022
Phase
Interventional
Are there results?
None posted in the registry

Key requirements

Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.

  • Ages 18 years and older
  • All sexes
  • Healthy volunteers accepted
  • Adult, Older adult

Who may be able to join

  • Consecutive patients undergoing elective and non-emergent TR LHC and/or PCI at the INOVA Heart and Vascular Institute
  • Able to provide informed consent.
  • Patients willing to complete a 90day post PCI radial artery ultrasound.

Who cannot join

  • Patients with previous cannulation of both the right and left forearm RA's for coronary angiography and/or PCI. In patients with prior cannulation of one RA, the contralateral arm may be used for this study.
  • Patients who are not willing to undergo the necessary follow-up ultrasound examinations.
  • ST elevation myocardial infarction or other emergent PCI
  • Inability to provide informed consent

Trial locations and contacts

1 site in 1 country.

United States1 site
  • Inova Fairfax Hospital

    Falls Church, Virginia, 22042

Other trials in United States

About this study

Official title: PRESERVE Radial: A PRospEctive Randomized Clinical Study Comparing Radial ArtERy Intimal Hyperplasia Following Distal Vs. ForEarm TransRadial Arterial Access for Coronary Angiography

Prospective randomized non-blinded study to determine degree of vessel trauma and adverse remodeling of the proximal forearm radial artery following distal radial artery access (dTRA) for cardiac catheterization compared to standard forearm transradial access (fTRA).

Read the detailed description

To determine degree of vessel trauma and adverse remodeling of the proximal forearm radial artery, using ultrahigh resolution (55 MHz) ultrasound, following distal radial artery access (dTRA) for cardiac catheterization compared to standard forearm transradial access (fTRA) at 90 days post-procedure. Secondary outcome measures will include metrics of procedural success at 24 hours, as well as functional assessment of pain and motor strength of the ipsilateral upper extremity at 90 days post-procedure.

Being tested
dTRA, fTRA

What participants receive

What participants receive. In a randomised study each person is assigned to one group by chance.

  • dTRAProcedure or surgery

    Subjects randomized to the experimental arm will undergo left heart catheterization, coronary angiography and/or percutaneous coronary intervention using distal transradial access (dTRA)

  • fTRAProcedure or surgery

    Left heart catheterization, coronary angiography and/or percutaneous coronary intervention using the left forearm radial artery.

Study groups in NCT04801901
Study groupRoleWhat they receive
Distal transradial access (dTRA)ExperimentalSubjects randomized to the experimental arm will undergo left heart catheterization using distal transradial access (dTRA) to facilitate coronary angiography and/or percutaneous coronary intervention.
Receives: Procedure: dTRA
Forearm radial access (fTRA)Active comparatorCardiac catheterization to facilitate coronary angiography and/or percutaneous coronary intervention using the standard forearm radial artery which is the current standard of care in interventional cardiology.
Receives: Procedure: fTRA

What is being measured

The primary outcome is the main question the study is designed to answer.

  1. Radial artery intimal medial thickness following dTRA and fTRA

    Intimal medial thickness (mm) of the forearm radial artery followed dTRA and fTRA as assessed using ultrahigh resolution 55 MHz ultrasound probe at 90 days post cardiac catheterization.

    Measured: 90 days post-cardiac catheterization.

Secondary outcomes (11)
  1. Radial artery trauma followed dTRA and fTRA

    Number of participants with limited access site intimal tears, dissections, thrombosis, occlusions and pseudoaneurysms of the radial artery as assessed using ultrahigh resolution 55 MHz ultrasound at the site of puncture at 90 days post cardiac catheterization

    Measured: 90 days post-cardiac catheterization

  2. Functional assessment of the ipsilateral upper extremity following dTRA and fTRA

    Pain and motor strength of the ipsilateral upper extremity using the Borg (0-none to 10-maximal) and Disabilities of the Arm, Shoulders and Hand (DASH) (0-no disability to 100-most severe disability) scales 90 days post-cardiac catheterization.

    Measured: 90 days post-cardiac catheterization

  3. Number of cannulation attempts

    Number of cannulation attempts prior to achieving successful vascular access

    Measured: 24 hours post-cardiac catheterization

  4. Radial artery access time

    Time (minutes) from initial attempt to successful access of the radial artery.

    Measured: 24 hours post-cardiac catheterization

  5. Access site crossover

    Number of patients with failure of radial artery cannulation requiring crossover to alternative radial artery access or transfemoral access

    Measured: 24 hours post-cardiac catheterization

  6. Total procedural time

    Total procedural time (minutes) from time of access to completion of the cardiac catheterization.

    Measured: 24 hours post-cardiac catheterization

  7. Duration of hemostasis

    Total duration of hemostasis (minutes) following completion of cardiac catheterization

    Measured: 24 hours post-cardiac catheterization

  8. Incidence of hematomas

    Number of patients with EASY Class III or greater hematomas

    Measured: 24 hours post-cardiac catheterization

  9. Percutaneous Coronary Intervention Success

    Achievement of Thrombolysis in Myocardial Infarction (TIMI) 3 flow following percutaneous coronary intervention

    Measured: 24 hours post-cardiac catheterization

  10. Coronary dissection

    Iatrogenic coronary dissection at the of cardiac catheterization

    Measured: 24 hours post-cardiac catheterization

  11. Myocardial infarction requiring revascularization

    Periprocedural myocardial infarction requiring urgent revascularization within 24 hours post-cardiac catheterization.

    Measured: 24 hours post-cardiac catheterization

Timeline

From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.

  1. First posted17 Mar 2021
  2. Study start1 Oct 2021
  3. Primary completion29 Jul 2022
  4. Study completion29 Jul 2022

Resources

More details

For doctors and researchers: how the study is designed, who runs it, and its registry IDs.

Study design
Study type
Interventional
Phase
Phase N/A
Primary purpose
Treatment
Allocation
Randomised
Intervention model
Parallel groups
Model description
Prospective randomized non-blinded study evaluating whether distal radial artery access (dTRA) from the anatomic snuffbox is associated with less trauma and adverse remodeling to the forearm radial artery compared to standardard forearm radial access (fTRA).
Masking
None (open label)
Enrolment
64 participants (actual)
IDs, dates and publications
ClinicalTrials.gov ID
NCT04801901
Sponsor's protocol ID
U20-04-4021
Status last verified
Aug 2022
First submitted
7 Jan 2021
Last updated
15 Aug 2022
Results posted
No
Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
Individual data sharing
Yes: Individual patient data including demographics, cardiac history indications for cardiac catheterization and all follow up data related to primary outcome, secondary ultrasound endpoints, interventional endpoints and secondary functional outcomes will be shared.

Publications

  • Campeau L. Percutaneous radial artery approach for coronary angiography. Cathet Cardiovasc Diagn. 1989 Jan;16(1):3-7. doi: 10.1002/ccd.1810160103.

    PubMed 2912567
  • Ferrante G, Rao SV, Juni P, Da Costa BR, Reimers B, Condorelli G, Anzuini A, Jolly SS, Bertrand OF, Krucoff MW, Windecker S, Valgimigli M. Radial Versus Femoral Access for Coronary Interventions Across the Entire Spectrum of Patients With Coronary Artery Disease: A Meta-Analysis of Randomized Trials. JACC Cardiovasc Interv. 2016 Jul 25;9(14):1419-34. doi: 10.1016/j.jcin.2016.04.014. Epub 2016 Jun 29.

    PubMed 27372195
  • Kopin D, Seth M, Sukul D, Dixon S, Aronow HD, Lee D, Tucciarone M, Pielsticker E, Gurm HS. Primary and Secondary Vascular Access Site Complications Associated With Percutaneous Coronary Intervention: Insights From the BMC2 Registry. JACC Cardiovasc Interv. 2019 Nov 25;12(22):2247-2256. doi: 10.1016/j.jcin.2019.05.051. Epub 2019 Aug 28.

    PubMed 31473240
  • Valle JA, Kaltenbach LA, Bradley SM, Yeh RW, Rao SV, Gurm HS, Armstrong EJ, Messenger JC, Waldo SW. Variation in the Adoption of Transradial Access for ST-Segment Elevation Myocardial Infarction: Insights From the NCDR CathPCI Registry. JACC Cardiovasc Interv. 2017 Nov 27;10(22):2242-2254. doi: 10.1016/j.jcin.2017.07.020. Epub 2017 Nov 1.

    PubMed 29102582
  • Mason PJ, Shah B, Tamis-Holland JE, Bittl JA, Cohen MG, Safirstein J, Drachman DE, Valle JA, Rhodes D, Gilchrist IC; American Heart Association Interventional Cardiovascular Care Committee of the Council on Clinical Cardiology; Council on Cardiovascular and Stroke Nursing; Council on Peripheral Vascular Disease; and Council on Genomic and Precision Medicine. An Update on Radial Artery Access and Best Practices for Transradial Coronary Angiography and Intervention in Acute Coronary Syndrome: A Scientific Statement From the American Heart Association. Circ Cardiovasc Interv. 2018 Sep;11(9):e000035. doi: 10.1161/HCV.0000000000000035.

    PubMed 30354598
  • Rashid M, Kwok CS, Pancholy S, Chugh S, Kedev SA, Bernat I, Ratib K, Large A, Fraser D, Nolan J, Mamas MA. Radial Artery Occlusion After Transradial Interventions: A Systematic Review and Meta-Analysis. J Am Heart Assoc. 2016 Jan 25;5(1):e002686. doi: 10.1161/JAHA.115.002686.

    PubMed 26811162
  • Kiemeneij F. Left distal transradial access in the anatomical snuffbox for coronary angiography (ldTRA) and interventions (ldTRI). EuroIntervention. 2017 Sep 20;13(7):851-857. doi: 10.4244/EIJ-D-17-00079.

    PubMed 28506941
  • Babunashvili A, Dundua D. Recanalization and reuse of early occluded radial artery within 6 days after previous transradial diagnostic procedure. Catheter Cardiovasc Interv. 2011 Mar 1;77(4):530-6. doi: 10.1002/ccd.22846.

    PubMed 20939038
  • Aoi S, Htun WW, Freeo S, Lee S, Kyaw H, Alfaro V, Coppola J, Pancholy S, Kwan T. Distal transradial artery access in the anatomical snuffbox for coronary angiography as an alternative access site for faster hemostasis. Catheter Cardiovasc Interv. 2019 Nov 1;94(5):651-657. doi: 10.1002/ccd.28155. Epub 2019 Feb 24.

    PubMed 30801939
  • Koutouzis M, Kontopodis E, Tassopoulos A, Tsiafoutis I, Katsanou K, Rigatou A, Didagelos M, Andreou K, Lazaris E, Oikonomidis N, Maniotis C, Ziakas A. Distal Versus Traditional Radial Approach for Coronary Angiography. Cardiovasc Revasc Med. 2019 Aug;20(8):678-680. doi: 10.1016/j.carrev.2018.09.018. Epub 2018 Oct 2.

    PubMed 30314833
  • Nairoukh Z, Jahangir S, Adjepong D, Malik BH. Distal Radial Artery Access: The Future of Cardiovascular Intervention. Cureus. 2020 Mar 7;12(3):e7201. doi: 10.7759/cureus.7201.

    PubMed 32269880
  • Shroff AR, Gulati R, Drachman DE, Feldman DN, Gilchrist IC, Kaul P, Lata K, Pancholy SB, Panetta CJ, Seto AH, Speiser B, Steinberg DH, Vidovich MI, Woody WW, Rao SV. SCAI expert consensus statement update on best practices for transradial angiography and intervention. Catheter Cardiovasc Interv. 2020 Feb;95(2):245-252. doi: 10.1002/ccd.28672. Epub 2019 Dec 27.

    PubMed 31880380
  • Roghani-Dehkordi F, Hashemifard O, Sadeghi M, Mansouri R, Akbarzadeh M, Dehghani A, Akbari M. Distal accesses in the hand (two novel techniques) for percutaneous coronary angiography and intervention. ARYA Atheroscler. 2018 Mar;14(2):95-100. doi: 10.22122/arya.v14i2.1743.

    PubMed 30108641
  • Sgueglia GA, Di Giorgio A, Gaspardone A, Babunashvili A. Anatomic Basis and Physiological Rationale of Distal Radial Artery Access for Percutaneous Coronary and Endovascular Procedures. JACC Cardiovasc Interv. 2018 Oct 22;11(20):2113-2119. doi: 10.1016/j.jcin.2018.04.045.

    PubMed 30336816
  • Batchelor W, Dahya V, McGee D, Katopodis J, Dixon W, Campbell J, Meredith A, Knap P, Parkin M, Noel T. Ultrahigh-resolution ultrasound characterization of access site trauma and intimal hyperplasia following use of a 7F sheathless guide versus 6F sheath/guide combination for transradial artery PCI: Results of the PRAGMATIC trial. Am Heart J. 2018 Apr;198:75-83. doi: 10.1016/j.ahj.2017.11.017. Epub 2017 Dec 15.

    PubMed 29653651

Questions about this trial

What is this clinical trial studying?

A study testing dTRA and fTRA in people with Transradial Access and Coronary Angiography, run by Inova Health Care Services at 1 site in United States.

The full registered description is in the About this study section and the official record.

Who may be eligible to take part?

The sponsor lists 3 inclusion and 4 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.

Is this clinical trial currently recruiting?

The record says: finished, as of the sponsor's last update on 15 Aug 2022. Status can change between updates, so confirm with the study contact before making plans.

Where is the study taking place?

The record lists 1 site in United States. Whether a site is taking part right now should be confirmed with that site. See every site.

What are the possible benefits and risks?

They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.

Are results available for this study?

The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.

How can a doctor refer a patient or contact the research team?

The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.

What does the primary outcome measure?

Radial artery intimal medial thickness following dTRA and fTRA (time frame: 90 days post-cardiac catheterization.). It is what the study was designed to measure, not a finding.

Where can I read the original study information?

On the ClinicalTrials.gov record for NCT04801901, which also lists 23 linked publications.

Does a listing mean the treatment is approved or proven to work?

No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.

How often is this information updated?

AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 15 Aug 2022.

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