ScholarWorks@중앙대학교

초록

BACKGROUND: Distal radial access (DRA) can be performed from either the right or left distal radial artery. However, comparative data between these two access routes remain limited. METHODS: Using data from the KODRA registry, we compared procedural outcomes between right (RDRA) and left DRA (LDRA). The primary endpoint was access-site crossover after successful puncture. Secondary endpoints included successful coronary angiography (CAG) via the initial access site, puncture success, overall access-site crossover, DRA-related bleeding, and procedure-related times. RESULTS: Among 4977 patients, RDRA showed a higher rate of access-site crossover (1.7% vs. 0.7%, p&#x202f;<&#x202f;0.001). Rates of successful CAG (92.5% vs. 93.8%, p&#x202f;=&#x202f;0.087), puncture success (94.2% vs. 94.5%, p&#x202f;=&#x202f;0.670), overall access-site crossover (7.5% vs. 6.2%, p&#x202f;=&#x202f;0.068), and DRA-related bleeding (3.0% vs. 3.4%, p&#x202f;=&#x202f;0.446) were comparable between groups. The times for arterial puncture and CAG were significantly shorter with RDRA than with LDRA (88.2&#x202f;&#xb1;&#x202f;115.4&#x202f;s vs. 107.9&#x202f;&#xb1;&#x202f;123.2&#x202f;s; 8.6&#x202f;&#xb1;&#x202f;6.7&#x202f;min vs. 10.9&#x202f;&#xb1;&#x202f;8.3&#x202f;min; both p&#x202f;<&#x202f;0.001), although procedural times were shorter when procedures were performed on the operators' preferred access side. In multivariable analysis, RDRA independently predicted access-site crossover after successful puncture (OR 2.156, 95% CI 1.184-3.926). CONCLUSIONS: Compared with LDRA, RDRA was associated with a higher risk of access-site crossover, whereas success rates of CAG and puncture, overall access-site crossover, and DRA-related bleeding were comparable. The shorter procedural times with RDRA were largely influenced by the operator's access-side preference. Copyright © 2026. Published by Elsevier B.V.

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