Distal Radial Artery Access in Noncoronary Procedures.

Since the beginning of interventional cardiology and for decades, the femoral artery has been the access of choice for both diagnostic and interventional endovascular procedures. Due to an extensive evidence base accumulated over the last 20 years, the majority of interventional cardiologists around the world prefer classical radial artery access for both elective and emergency procedures. A similar trend has been observed for distal radial artery access over the last 5 years. Noncoronary endovascular surgery undergoes the same stages of improvement and optimization of access, but in a more accelerated way. The goal of this review is to analyze the literature on distal radial artery access in noncoronary procedures.

A narrative review of history, advantages, future developments of the distal radial access.

This article presents a historical excursus and a review of modern literature on distal radial access for interventional surgery, discussing the anatomical and physiological substantiation of the use of this access point in endovascular surgery, its advantages and disadvantages. The main considerations directly related to distal puncture, choice of instrumentation, hemostasis, possible complications, and prevention are analyzed. The major areas of interventional surgery (coronary, vascular, oncological, and neurointerventional), where the distal radial approach is actively used, are reflected and their characteristics are highlighted. In general, it has been shown that with the development of technology, improved manual skills, the widespread use of hydrophilic introducers, and modern sheathless guiding catheters, the vessel diameter, and puncture site are not decisive factors when choosing access for any type of intervention.