{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,24]],"date-time":"2026-10-24T01:19:38Z","timestamp":1792804778198,"version":"4.5.0"},"reference-count":23,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T00:00:00Z","timestamp":1766448000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,1,26]],"date-time":"2026-01-26T00:00:00Z","timestamp":1769385600000},"content-version":"vor","delay-in-days":34,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"name":"Beijing Natural Science Foundation","award":["No.7254405"],"award-info":[{"award-number":["No.7254405"]}]},{"name":"CAMS Innovation Fund for Medical Sciences","award":["2022-I2M-C&T-B-048"],"award-info":[{"award-number":["2022-I2M-C&T-B-048"]}]},{"name":"the Capital's Funds for Health Improvement and Research","award":["CFH 2024-2-4035"],"award-info":[{"award-number":["CFH 2024-2-4035"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Cardiovasc Disord"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Transradial access (TRA) is the standard vascular approach for coronary interventions because it lowers bleeding risk and improves patient comfort. Nevertheless, radial artery occlusion (RAO) remains an important limitation, preventing re-use of the radial artery for subsequent procedures. Distal transradial access (dTRA) has been proposed as a strategy to further reduce RAO while preserving procedural efficacy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Aims<\/jats:title>\n                    <jats:p>To assess whether dTRA reduces early and mid-term RAO compared with conventional TRA in patients undergoing percutaneous coronary intervention (PCI).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      In this single-center, prospective, randomized, open-label superiority trial, 426 consecutive patients scheduled for elective PCI between July 2023 and January 2024 were assigned 1:1 to dTRA (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009213) or TRA (\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009213). Duplex ultrasonography was used to assess RAO at 24\u00a0h and 30 days. Primary endpoint: 24-hour RAO; secondary endpoints: 30-day RAO, procedural success, hemostasis time, radiation exposure, and hand\/wrist function scores.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      One patient withdrew consent, leaving 425 patients (dTRA 213, TRA 212) for analysis. The 24-hour RAO rate was significantly lower in the dTRA group compared to the TRA group (0.5% vs. 8.7%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). At 30 days, RAO remained lower in the dTRA group (1.6% vs. 8.2%,\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Median hemostasis time was 3.0\u00a0h with dTRA versus 6.0\u00a0h with TRA (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Procedural success was comparable between groups (82.2% vs. 80.2%;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.72), as was the fluoroscopy dose (1630.0 mGy [1069.0\u20132481.0] vs. 1598.0 mGy [1039.0\u20132512.0],\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.73). Early wrist function scores were marginally better in the dTRA group (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009=\u20090.048).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>In elective PCI patients, dTRA significantly reduces RAO incidence and shortens hemostasis time compared to TRA, without compromising procedural success or increasing radiation exposure, while modestly improving early hand function. These data support routine adoption of dTRA for coronary interventions.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Trial registration<\/jats:title>\n                    <jats:p>Chinese Clinical Trial Registry: ChiCTR2300073902 (registered on 25 July 2023).<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12872-025-05456-3","type":"journal-article","created":{"date-parts":[[2025,12,23]],"date-time":"2025-12-23T22:46:35Z","timestamp":1766529995000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Distal transradial access for percutaneous coronary intervention: a single-center randomized controlled study (DRAGON study)"],"prefix":"10.1186","volume":"26","author":[{"given":"Minghao","family":"Liu","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yuan","family":"Du","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheng","family":"Cui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinwei","family":"Zhai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wei","family":"Yu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hao","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hongmei","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiongwei","family":"He","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhenxi","family":"Shao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yana","family":"Tong","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yan","family":"Liu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Xiaoyang","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Na","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ang","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fujian","family":"Duan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hui","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiying","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Can","family":"Li","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yang","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ying","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lei","family":"Song","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jue","family":"Chen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jinqing","family":"Yuan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Weixian","family":"Yang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yongjian","family":"Wu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zhan","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Huanhuan","family":"Wang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lijian","family":"Gao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2025,12,23]]},"reference":[{"issue":"38","key":"5456_CR1","doi-asserted-by":"publisher","first-page":"3720","DOI":"10.1093\/eurheartj\/ehad191","volume":"44","author":"RA Byrne","year":"2023","unstructured":"Byrne RA, Rossello X, Coughlan JJ, Barbato E, Berry C, Chieffo A, Claeys MJ, Dan GA, Dweck MR, Galbraith M, et al. 2023 ESC guidelines for the management of acute coronary syndromes. Eur Heart J. 2023;44(38):3720\u2013826.","journal-title":"Eur Heart J"},{"issue":"11","key":"5456_CR2","first-page":"102294","volume":"3","author":"JE Tamis-Holland","year":"2024","unstructured":"Tamis-Holland JE, Abbott JD, Al-Azizi K, Barman N, Bortnick AE, Cohen MG, Dehghani P, Henry TD, Latif F, Madjid M, et al. SCAI expert consensus statement on the management of patients with STEMI referred for primary PCI. J Soc Cardiovasc Angiogr Interv. 2024;3(11):102294.","journal-title":"J Soc Cardiovasc Angiogr Interv"},{"issue":"4","key":"5456_CR3","doi-asserted-by":"publisher","first-page":"378","DOI":"10.1016\/j.jcin.2020.10.013","volume":"14","author":"G Eid-Lidt","year":"2021","unstructured":"Eid-Lidt G, Rivera Rodriguez A, Jimenez Castellanos J, Farjat Pasos JI, Estrada Lopez KE, Gaspar J. Distal radial artery approach to prevent radial artery occlusion trial. JACC Cardiovasc Interv. 2021;14(4):378\u201385.","journal-title":"JACC Cardiovasc Interv"},{"issue":"1","key":"5456_CR4","doi-asserted-by":"publisher","first-page":"49","DOI":"10.5603\/CJ.a2019.0085","volume":"28","author":"Y Fan","year":"2021","unstructured":"Fan Y, Wei Q, Cai J, Wang Y, Fu X. Comparison of long-term radial artery occlusion following trans-radial coronary intervention using 6-french versus 7-french sheaths. Cardiol J. 2021;28(1):49\u201357.","journal-title":"Cardiol J"},{"issue":"6","key":"5456_CR5","doi-asserted-by":"publisher","first-page":"e1","DOI":"10.1097\/MCA.0000000000001489","volume":"36","author":"MAT Mahmoud","year":"2025","unstructured":"Mahmoud MAT, Hamam NG, Ghanm TIE, Khaled A, Osman ASA, Beddor A, Elhaddad IM, Ibrahim AI. Comparing distal and proximal radial access for percutaneous coronary intervention and angiography: a comprehensive meta-analysis and systematic review of randomized controlled trials. Coron Artery Dis. 2025;36(6):e1\u201311.","journal-title":"Coron Artery Dis"},{"issue":"6","key":"5456_CR6","doi-asserted-by":"publisher","first-page":"1281","DOI":"10.1016\/j.jcmg.2020.11.023","volume":"14","author":"GA Sgueglia","year":"2021","unstructured":"Sgueglia GA, Santoliquido A, Gaspardone A, Di Giorgio A. First results of the distal radial access doppler study. JACC Cardiovasc Imaging. 2021;14(6):1281\u20133.","journal-title":"JACC Cardiovasc Imaging"},{"issue":"22","key":"5456_CR7","doi-asserted-by":"publisher","first-page":"2235","DOI":"10.1016\/j.jcin.2019.07.043","volume":"12","author":"I Bernat","year":"2019","unstructured":"Bernat I, Aminian A, Pancholy S, Mamas M, Gaudino M, Nolan J, Gilchrist IC, Saito S, Hahalis GN, Ziakas A, et al. Best practices for the prevention of radial artery occlusion after transradial diagnostic angiography and intervention: an international consensus paper. JACC Cardiovasc Interv. 2019;12(22):2235\u201346.","journal-title":"JACC Cardiovasc Interv"},{"issue":"7","key":"5456_CR8","doi-asserted-by":"publisher","first-page":"851","DOI":"10.4244\/EIJ-D-17-00079","volume":"13","author":"F Kiemeneij","year":"2017","unstructured":"Kiemeneij F. Left distal transradial access in the anatomical snuffbox for coronary angiography (ldTRA) and interventions (ldTRI). EuroIntervention. 2017;13(7):851\u20137.","journal-title":"EuroIntervention"},{"issue":"3","key":"5456_CR9","doi-asserted-by":"publisher","first-page":"329","DOI":"10.1016\/j.jcin.2023.11.021","volume":"17","author":"JW Lee","year":"2024","unstructured":"Lee JW, Kim Y, Lee BK, Yoo SY, Lee SY, Kim CJ, Jin HY, Park JS, Heo JH, Kim DH, et al. Distal radial access for coronary procedures in a large prospective multicenter registry: the KODRA trial. JACC Cardiovasc Interv. 2024;17(3):329\u201340.","journal-title":"JACC Cardiovasc Interv"},{"issue":"9","key":"5456_CR10","doi-asserted-by":"publisher","first-page":"e014186","DOI":"10.1161\/CIRCINTERVENTIONS.124.014186","volume":"17","author":"MH Maqsood","year":"2024","unstructured":"Maqsood MH, Yong CM, Rao SV, Cohen MG, Pancholy S, Bangalore S. Procedural outcomes with Femoral, Radial, distal Radial, and ulnar access for coronary angiography: A network Meta-Analysis. Circ Cardiovasc Interv. 2024;17(9):e014186.","journal-title":"Circ Cardiovasc Interv"},{"key":"5456_CR11","doi-asserted-by":"publisher","unstructured":"Cardoso CO, Li K, Moctezuma-Ramirez A, Hanna F, Ribeiro MH, Megaly MS, Azzalini L, Elgalad A, Perin EC. Radiation exposure during distal and traditional radial coronary angiography and percutaneous coronary intervention: a meta-analysis of randomized controlled trials. J Invasive Cardiol. 2023;35(11). [online only] https:\/\/doi.org\/10.25270\/jic\/23.00206","DOI":"10.25270\/jic\/23.00206"},{"key":"5456_CR12","doi-asserted-by":"publisher","first-page":"7698583","DOI":"10.1155\/2022\/7698583","volume":"2022","author":"Y Daralammouri","year":"2022","unstructured":"Daralammouri Y, Nazzal Z, Mosleh YS, Abdulhaq HK, Khayyat ZY, Hamshary YE, Azamtta M, Ghanim A, Awwad F, Majadla S, et al. Distal Radial Artery Access in comparison to Forearm Radial Artery Access for Cardiac Catheterization: A Randomized Controlled Trial (DARFORA Trial). J Interv Cardiol. 2022;2022:7698583.","journal-title":"J Interv Cardiol"},{"key":"5456_CR13","doi-asserted-by":"publisher","unstructured":"Liu M, Wang H, Gao L, Chen J, Cui C, Song Y, Zhang H, Yu W, Lang X, Zhao H et al. Protocol for a Single-Center randomized controlled trial of percutaneous coronary intervention via distal transradial access versus transradial access. Cardiovasc Innov Appl. 2024;9(1). [online only] https:\/\/doi.org\/10.15212\/CVIA.2024.0015","DOI":"10.15212\/CVIA.2024.0015"},{"issue":"3","key":"5456_CR14","first-page":"335","volume":"72","author":"S Pancholy","year":"2008","unstructured":"Pancholy S, Coppola J, Patel T, Roke-Thomas M. Prevention of radial artery occlusion-patent hemostasis evaluation trial (PROPHET study): a randomized comparison of traditional versus patency documented hemostasis after transradial catheterization. Catheter Cardiovasc Interv. 2008;72(3):335\u201340.","journal-title":"Catheter Cardiovasc Interv"},{"issue":"1","key":"5456_CR15","doi-asserted-by":"publisher","first-page":"13","DOI":"10.2340\/1650197771331","volume":"7","author":"AR Fugl-Meyer","year":"1975","unstructured":"Fugl-Meyer AR, Jaasko L, Leyman I, Olsson S, Steglind S. The post-stroke hemiplegic patient. 1. a method for evaluation of physical performance. Scand J Rehabil Med. 1975;7(1):13\u201331.","journal-title":"Scand J Rehabil Med"},{"issue":"1","key":"5456_CR16","doi-asserted-by":"publisher","first-page":"22","DOI":"10.1016\/j.jcin.2021.09.037","volume":"15","author":"G Tsigkas","year":"2022","unstructured":"Tsigkas G, Papageorgiou A, Moulias A, Kalogeropoulos AP, Papageorgopoulou C, Apostolos A, Papanikolaou A, Vasilagkos G, Davlouros P. Distal or traditional transradial access site for coronary procedures: A Single-Center, randomized study. JACC Cardiovasc Interv. 2022;15(1):22\u201332.","journal-title":"JACC Cardiovasc Interv"},{"issue":"4","key":"5456_CR17","doi-asserted-by":"publisher","first-page":"360","DOI":"10.1055\/s-0030-1267849","volume":"27","author":"BW Cook","year":"2010","unstructured":"Cook BW. Anticoagulation management. Semin Intervent Radiol. 2010;27(4):360\u20137.","journal-title":"Semin Intervent Radiol"},{"key":"5456_CR18","doi-asserted-by":"publisher","unstructured":"Kozinski L, Orzalkiewicz Z, Zagozdzon P, Dabrowska-Kugacka A. Distal transradial access optimization: a prospective trial of ultrasound-guided radial artery characterization for the anatomical snuffbox. Diagnostics (Basel). 2024;14(18). [online only] https:\/\/doi.org\/10.3390\/diagnostics14182081","DOI":"10.3390\/diagnostics14182081"},{"key":"5456_CR19","doi-asserted-by":"publisher","first-page":"2560659","DOI":"10.1155\/2023\/2560659","volume":"2023","author":"H Wang","year":"2023","unstructured":"Wang H, Liu D, Guo J, Heisha N, Wang L, Zhang Q, Han Y, Wang X, Zhang B, Yuan J, et al. Analysis of the efficacy and safety of coronary catheterization through distal transradial access: A Single-Center data. Cardiovasc Ther. 2023;2023:2560659.","journal-title":"Cardiovasc Ther"},{"key":"5456_CR20","doi-asserted-by":"publisher","unstructured":"Liu M, Wang H, Gao L, Zhai J, Liu H, Cui C, Song Y, Chen Y, Gao Z, Liu H et al. Intravenous Protamine sulfate shortens compression time after coronary angiography via distal transradial access. Cardiovasc Innov Appl. 2025;10(1). [online only] https:\/\/doi.org\/10.15212\/CVIA.2024.0062","DOI":"10.15212\/CVIA.2024.0062"},{"issue":"4","key":"5456_CR21","first-page":"2201","volume":"106","author":"C Yan","year":"2025","unstructured":"Yan C, Yang T, Li-Jian G, Huan-Huan W, Ping J, Ying S, Jing-Jing X, Pei Z, Cheng C, Jue C, et al. Protamine-Facilitated Same-Day discharge following distal transradial angiography. Catheter Cardiovasc Interv. 2025;106(4):2201\u20136.","journal-title":"Catheter Cardiovasc Interv"},{"issue":"12","key":"5456_CR22","doi-asserted-by":"publisher","first-page":"1191","DOI":"10.1016\/j.jcin.2022.04.032","volume":"15","author":"A Aminian","year":"2022","unstructured":"Aminian A, Sgueglia GA, Wiemer M, Kefer J, Gasparini GL, Ruzsa Z, van Leeuwen MAH, Ungureanu C, Leibundgut G, Vandeloo B, et al. Distal versus conventional radial access for coronary angiography and intervention: the DISCO RADIAL trial. JACC Cardiovasc Interv. 2022;15(12):1191\u2013201.","journal-title":"JACC Cardiovasc Interv"},{"issue":"3","key":"5456_CR23","doi-asserted-by":"publisher","first-page":"e18330","DOI":"10.1097\/MD.0000000000018330","volume":"99","author":"W Yu","year":"2020","unstructured":"Yu W, Hu P, Wang S, Yao L, Wang H, Dou L, Lu M, Bo G, Yu X, Chen J, et al. Distal radial artery access in the anatomical snuffbox for coronary angiography and intervention: A single center experience. Med (Baltim). 2020;99(3):e18330.","journal-title":"Med (Baltim)"}],"container-title":["BMC Cardiovascular Disorders"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/article\/10.1186\/s12872-025-05456-3","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-025-05456-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/s12872-025-05456-3.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,1,27]],"date-time":"2026-01-27T04:56:23Z","timestamp":1769489783000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1186\/s12872-025-05456-3"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,23]]},"references-count":23,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2026,12]]}},"alternative-id":["5456"],"URL":"https:\/\/doi.org\/10.1186\/s12872-025-05456-3","relation":{},"ISSN":["1471-2261"],"issn-type":[{"value":"1471-2261","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,12,23]]},"assertion":[{"value":"6 September 2025","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"15 December 2025","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 December 2025","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the Ethics Committee of Fuwai Hospital, Chinese Academy of Medical Sciences & Peking Union Medical College (Approval No. 2023\u2009\u2212\u20091931). Informed consent was obtained from all participants prior to enrollment. The study adhered to the principles of the Declaration of Helsinki and Good Clinical Practice guidelines.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval and consent to participate"}},{"value":"All participants provided written informed consent for publication of their anonymized data.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for publication"}},{"value":"The authors declare no competing interests.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}],"article-number":"77"}}