{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T06:26:20Z","timestamp":1787034380236,"version":"build-2736575974"},"reference-count":38,"publisher":"Wiley","license":[{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,8,17]],"date-time":"2026-08-17T00:00:00Z","timestamp":1786924800000},"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"],"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Distal radial access (DRA) has emerged as an alternative to conventional transradial access (TRA) for percutaneous coronary procedures, with potential advantages for reducing radial artery occlusion (RAO).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aim<\/jats:title>\n                    <jats:p>To assess whether favorable outcomes observed in randomized trials are consistently reproduced in routine clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      A structured comparative analysis was performed between the largest randomized controlled trial of DRA (DISCO RADIAL; 650 patients, 16 centers, strict selection criteria, experienced operators) and the largest real\u2010world DRA registry (KODRA; 4977 consecutive patients, 14 centers, broader inclusion criteria, heterogeneous operator experience). Access\u2010related outcomes were summarized using inverse variance\u2013weighted estimates and analyzed using random\u2010effects models to assess agreement across clinical settings, with absolute differences as the primary measure. Heterogeneity (I\n                      <jats:sup>2<\/jats:sup>\n                      ) was reported descriptively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Despite marked differences in study design, patient populations (body surface area 2.0 vs. 1.7\u2009m\n                      <jats:sup>2<\/jats:sup>\n                      ), and operator experience (100% vs. 70% with \u2265\u2009100 DRA cases), concordance was remarkable. RAO at discharge was 0.18% (95% CI 0.07%\u20130.29%, I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%). Overall crossover occurred in 6.8% (95% CI 6.1%\u20137.4%, I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u20090%), with same\u2010side conventional TRA as predominant bailout (4.3%). Femoral access was required in only 1.3% of cases. No serious bleeding events occurred in either study. Minor bleeding and hematoma showed considerable heterogeneity (I\n                      <jats:sup>2<\/jats:sup>\n                      \u2009=\u200980%\u201398%), likely reflecting differences in surveillance and practice patterns. Sensitivity analyses confirmed the stability of crossover and RAO estimates.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>DRA demonstrates very low RAO rates, high procedural success, and favorable safety, with consistent performance across controlled and real\u2010world settings, supporting its feasibility in routine clinical practice.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/ccd.70832","type":"journal-article","created":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T05:51:01Z","timestamp":1787032261000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Concordance Between Randomized Controlled and Real\u2010World Evidence for Distal Radial Access: A Structured Comparison of the DISCO RADIAL Trial and KODRA Study"],"prefix":"10.1002","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9680-7412","authenticated-orcid":false,"given":"Gregory A.","family":"Sgueglia","sequence":"first","affiliation":[{"name":"Division of Cardiology Sant'Eugenio Hospital Rome Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adel","family":"Aminian","sequence":"additional","affiliation":[{"name":"Department of Cardiology Centre Hospitalier Universitaire de Charleroi Charleroi Belgium"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongcheol","family":"Kim","sequence":"additional","affiliation":[{"name":"Yongin Severance Hospital Yonsei University College of Medicine Yongin South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Juan F.","family":"Iglesias","sequence":"additional","affiliation":[{"name":"Department of Cardiology Geneva University Hospitals Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4289-2284","authenticated-orcid":false,"given":"Bong\u2010Ki","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine Kangwon National University Hospital, Kangwon National University School of Medicine Chuncheon South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivo","family":"Bernat","sequence":"additional","affiliation":[{"name":"Department of Cardiology University Hospital and Faculty of Medicine Pilsen, Charles University Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1386-349X","authenticated-orcid":false,"given":"Sang Yeub","family":"Lee","sequence":"additional","affiliation":[{"name":"Chung\u2010Ang University Gwangmyeong Hospital, Chung\u2010Ang University College of Medicine Gwangmyeong South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jin Bae","family":"Lee","sequence":"additional","affiliation":[{"name":"Division of Cardiology, Department of Internal Medicine Daegu Catholic University Medical Center Daegu South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maarten A. 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