Effectiveness of the Anatomical Snuff Box Approach for Coronary Angiography

NCT ID: NCT05725616

Last Updated: 2025-11-24

Basic Information

• Recruitment Status: COMPLETED
• Clinical Phase: NA
• Total Enrollment: 326 participants
• Study Classification: INTERVENTIONAL
• Study Start Date: 2023-07-01
• Study Completion Date: 2025-01-01

Brief Summary

The main objective of the study is to assess whether the distal radial arterial approach (snuff box or back of the hand) is not inferior to the radial arterial approach at the wrist, in the management of coronary angiography for diagnostic purposes

Detailed Description

Coronary angiography is the reference examination for anatomical exploration coronary arteries to determine the presence or absence of a predominantly obstructive coronary disease.

Historically, the femoral approach was the most common approach used in interventional cardiology. The radial approach to the forearm presents multiple advantages over the femoral route, and it became the gold standard approach to coronary angiography and intervention percutaneous coronary. Although uncommon, vascular complications related to the radial pathway exist.

This is why a more distal radial approach, above the long tendon extensor of the thumb (at the level of the anatomical snuff box) or downstream (at the back of the hand) was suggested more than 10 years ago. This pathway is now an advantageous alternative to the radial approach of first intention, both for the patient and for the practitioner.

The two procedures are common today but few studies have been developed to compare the two approaches. Therefore, the main objective of the study is to assess whether the distal radial arterial approach (snuff box or back of the hand) is not inferior to the radial arterial approach at the wrist, in the management of coronary angiography for diagnostic purposes

Conditions

Coronary Angiography

Study Design

• Allocation Method: RANDOMIZED
• Intervention Model: PARALLEL
• Primary Study Purpose: OTHER
• Blinding Strategy: NONE

Study Groups

Snuff box puncture

Puncture of the radial artery at of the anatomical snuff box or on the back of the hand during coronary angiography

Group Type: EXPERIMENTAL

Coronary angiography

Intervention Type: PROCEDURE

Snuff Box Approach or radial Arterial Approach at wrist for coronary angiography.

Wrist puncture

Puncture of the radial artery at the level of the base of the wrist during coronary angiography

Group Type: ACTIVE_COMPARATOR

Coronary angiography

Intervention Type: PROCEDURE

Snuff Box Approach or radial Arterial Approach at wrist for coronary angiography.

Interventions

Coronary angiography

Snuff Box Approach or radial Arterial Approach at wrist for coronary angiography.

Intervention Type: PROCEDURE

Eligibility Criteria

Inclusion Criteria

• Patient, male or female, aged 18 and over
• Patient having a diagnostic coronary angiography programmed by radial route.
• Patient with a radial pulse at the anatomical snuff box and at the wrist noticeable

Exclusion Criteria

• Patient requiring emergency coronary angiography or having an acute coronary syndrome
• Patient with severe arteriopathy of the supra-aortic trunks
• Patient with a history of coronary bypass surgery
• Tall patients (>1.90m)
• Patient allergic to xylocaine
• Patient presenting a contraindication to the realization of a coronary angiography:

terminal IRC, pregnancy, severe sepsis....

• Minimum Eligible Age: 18 Years
• Eligible Sex: ALL
• Accepts Healthy Volunteers: No

Sponsors

GCS Ramsay Santé pour l'Enseignement et la Recherche

OTHER

Sponsor Role: lead

Responsible Party

Responsibility Role: SPONSOR

Locations

Cardiologie Tonkin

Villeurbanne, , France

Countries

France

Other Identifiers

2022-A01928-35

Identifier Type: -

Identifier Source: org_study_id