{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T13:20:20Z","timestamp":1788268820943,"version":"build-2803163510"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T00:00:00Z","timestamp":1784160000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Cathet Cardio Intervent"],"published-print":{"date-parts":[[2026,9]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Radial artery spasm (RAS) remains a clinically relevant limitation of the transradial approach (TRA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>This study aimed to evaluate the influence of the distance between the radial artery puncture site and the radial styloid process on RAS and access\u2010site complications.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective, single\u2010center, randomized, single\u2010blind trial enrolled 380 patients undergoing diagnostic coronary angiography or percutaneous coronary intervention via TRA. Using fluoroscopic identification of the radial styloid process as a fixed anatomical reference, patients were randomized 1:1 to Near\u2010Styloid (0\u201320\u2009mm) or Far\u2010Styloid (21\u201340\u2009mm) puncture. The primary endpoint was clinical RAS. Secondary endpoints included puncture efficiency, pain scores, crossover, and access\u2010site complications, including radial artery occlusion (RAO) and hematoma.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Clinical RAS occurred in 14.7% of the Near\u2010Styloid group and 17.9% of the Far\u2010Styloid group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.488). First\u2010attempt puncture success was significantly higher with Near\u2010Styloid access (74.2% vs. 58.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.002), with shorter puncture time (median 20 vs. 30\u2009s,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and fewer puncture attempts (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.003). Procedural characteristics and fluoroscopy parameters were similar between groups. Persistent forearm pain (3.2% vs. 8.4%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048), RAO (1.6% vs. 6.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.019), and access\u2010site hematoma (1.1% vs. 5.8%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.020) were less frequent in the Near\u2010Styloid group.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>No statistically significant difference in clinical RAS was detected between puncture sites located closer to or farther from the radial styloid process. Near\u2010Styloid access was associated with improved puncture efficiency and lower rates of RAO and access\u2010site hematoma. As these findings were derived from secondary endpoint analyses, they should be considered exploratory and warrant confirmation in future multicenter studies.<\/jats:p>\n                    <jats:p>\n                      <jats:bold>Trial Registration:<\/jats:bold>\n                      <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" xlink:href=\"http:\/\/ClinicalTrials.gov\">ClinicalTrials.gov<\/jats:ext-link>\n                      identifier: NCT07060820.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70754","type":"journal-article","created":{"date-parts":[[2026,7,16]],"date-time":"2026-07-16T10:54:39Z","timestamp":1784199279000},"page":"1099-1107","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effect of the Distance Between the Radial Artery Puncture Site and the Styloid Process on Radial Artery Spasm in Transradial Coronary Interventions: A Randomized Study"],"prefix":"10.1002","volume":"108","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-5415-5812","authenticated-orcid":false,"given":"Vedat","family":"Aslan","sequence":"first","affiliation":[{"name":"Vocational School of Health Service Toros University Mersin Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-4628-6672","authenticated-orcid":false,"given":"Sefa","family":"Sural","sequence":"additional","affiliation":[{"name":"Vocational School of Health Service Toros University Mersin Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1867-181X","authenticated-orcid":false,"given":"Nurettin","family":"Yeral","sequence":"additional","affiliation":[{"name":"Department of Cardiology Hatay Training and Research Hospital Hatay Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4775-1402","authenticated-orcid":false,"given":"\u015eevket","family":"Gorgulu","sequence":"additional","affiliation":[{"name":"Cardiology Department Biruni University School of Medicine Istanbul Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9416-9701","authenticated-orcid":false,"given":"Emmanouil S.","family":"Brilakis","sequence":"additional","affiliation":[{"name":"Minneapolis Heart Institute and Minneapolis Heart Institute Foundation Minneapolis Minnesota USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,7,16]]},"reference":[{"issue":"13","key":"e_1_2_12_2_1","first-page":"e771","article-title":"2025 ACC\/AHA\/ACEP\/NAEMSP\/SCAI Guideline for the Management of Patients With Acute Coronary Syndromes","volume":"151","author":"Rao S. 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J.","year":"2018","journal-title":"JACC: Cardiovascular Interventions"},{"key":"e_1_2_12_14_1","first-page":"211","article-title":"Prevention and Management of Radial Artery Spasm During Transradial Procedures","volume":"83","author":"Kiemeneij F.","year":"2014","journal-title":"Catheterization and Cardiovascular Interventions"},{"key":"e_1_2_12_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2022.09.032"},{"key":"e_1_2_12_16_1","first-page":"1","article-title":"Pharmacological Prevention of Radial Artery Spasm in Transradial Coronary Angiography and Intervention","volume":"39","author":"Tsigkas G.","year":"2022","journal-title":"Cardiovascular Revascularization Medicine: Including Molecular Interventions"},{"key":"e_1_2_12_17_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.106.638627"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/11297298241233713"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1177\/11297298221126284"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.4103\/0366-6999.179795"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.31675"}],"container-title":["Catheterization and Cardiovascular Interventions"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70754","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/ccd.70754","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/ccd.70754","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T12:44:48Z","timestamp":1788266688000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/ccd.70754"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,7,16]]},"references-count":20,"journal-issue":{"issue":"3","published-print":{"date-parts":[[2026,9]]}},"alternative-id":["10.1002\/ccd.70754"],"URL":"https:\/\/doi.org\/10.1002\/ccd.70754","archive":["Portico"],"relation":{},"ISSN":["1522-1946","1522-726X"],"issn-type":[{"value":"1522-1946","type":"print"},{"value":"1522-726X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,7,16]]},"assertion":[{"value":"2026-01-18","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-09","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-16","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}