Distal transradial access (dTRA) has recently emerged as a new vascular access alternative for coronary angiography (CAG) and/or percutaneous coronary intervention (PCI). However, published data on long-term mortality and major adverse cardiac events after PCI via dTRA are inconclusive. The aim of this study was to compare the long-term prognoses of PCI via dTRA and conventional transradial access (cTRA) for acute coronary syndrome (ACS) after 1–3 years of follow-up. Patients who were diagnosed with ACS and underwent PCI between January 1, 2020 and December 31, 2021, were retrospectively enrolled. The patients were divided into two groups at a 1:1 ratio, subjected to propensity score matching (PSM), and then followed for 1–3 years after PCI. Cox proportional hazards regression was used to evaluate the relationship between the two access sites and clinical outcomes. Among the 550 patients in the dTRA and cTRA groups, 11 (4.0%) and 19 (6.9%) died during the observation period, respectively. dTRA and cTRA had similar risks of all-cause mortality [hazard ratio (HR) = 0.688; 95% CI = 0.323–1.463; = 0.331] and major adverse cardiac events (MACEs, HR = 0.806, 95% CI = 0.515–1.263; = 0.347) after PCI. The risk of cardiovascular mortality (HR = 0.330, 95% CI = 0.107–1.105; = 0.053), TLR-MACEs (HR = 0.587, 95% CI = 0.339–1.109; = 0.058), and unplanned revascularization (HR = 0.860, 95% CI = 0.483–1.529; = 0.606) were not significantly different between the two groups. PCI via dTRA has the same long-term prognoses as PCI via cTRA in ACS patients, and the compression time and bleeding rate are lower than those in patients undergoing PCI via cTRA.

中文翻译：

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经远端经桡动脉入路与传统经桡动脉入路经皮冠状动脉介入治疗急性冠脉综合征的长期预后比较

远端经桡动脉通路 (dTRA) 最近已成为冠状动脉造影 (CAG) 和/或经皮冠状动脉介入治疗 (PCI) 的新血管通路替代方案。然而，已发表的有关通过 dTRA 进行 PCI 后长期死亡率和主要不良心脏事件的数据尚无定论。本研究的目的是比较经 dTRA 和传统经桡动脉入路 (cTRA) 进行 PCI 治疗急性冠脉综合征 (ACS) 1-3 年随访后的长期预后。回顾性纳入2020年1月1日至2021年12月31日期间诊断为ACS并接受PCI的患者。将患者按1：1的比例分为两组，进行倾向评分匹配（PSM），并在PCI后随访1-3年。Cox比例风险回归用于评估两个接入部位与临床结果之间的关系。dTRA 和 cTRA 组的 550 名患者中，观察期间分别有 11 名（4.0%）和 19 名（6.9%）死亡。dTRA 和 cTRA 的全因死亡风险相似[风险比 (HR) = 0.688；95% CI = 0.323–1.463；= 0.331] 和 PCI 后主要不良心脏事件（MACE，HR = 0.806，95% CI = 0.515–1.263；= 0.347）。心血管死亡风险（HR = 0.330，95% CI = 0.107–1.105；= 0.053）、TLR-MACE（HR = 0.587，95% CI = 0.339–1.109；= 0.058）和非计划血运重建（HR = 0.860， 95% CI = 0.483–1.529; = 0.606) 两组之间没有显着差异。对于ACS患者，dTRA PCI与cTRA PCI具有相同的长期预后，且按压时间和出血率低于cTRA PCI患者。