Transradial vs Transfemoral Access for Cerebral Angiography

作者：Wei Ni, Heng Yang, Jiabin Su, Ya Peng, D. Y. Wang, Zhiqing Lin, Jun Sun, Xuelin Chen, Jiyue Wang, Yi Li, J Wang, Shu Wan, Xin Ye, Qingrong Zhang, D Wang, Chong Gao, Hanqiang Jiang, Xinjie Gao, Yingying Zhang, Bing Han, Jie Cao, Xucheng Zhu, Shengjun Zhou, Yiyong Zeng, Fuxiang Chen, Yuanxiang Lin, Huajun Ba, Xiaoxiang Chen, Xia Liu, Jiheng Hao, Zhao-Liang Sun, Mei Li, Ming Wang, Dajiang Xie, Zong Zhuang, Lin Shi, Liang Zhou, Hongyu Tang, Dan Chen, Craig S. Anderson, Dezhi Kang, Yuxiang Gu, TRACE Investigators, Zhiwen Jiang, Ruiyuan Weng, Yuchao Fei, Zeran Yu, Zhou Hu, Yingtao Liu, Jun Ying, H. J. Yang, Yuan Cheng, Ronghua Chen, Junjun Zhang, Linsun Dai, Xiaoyu Lin, Quan Gu, Lin Zhou, Liyong Zhang, Meng Zhang, Zidong Wang, Fukai Ma, Yang Wang, Xitao Zong, Lin Li, Ning Wang, Yuhai Gao, Jixi Xie, Xin Lou, Haiping Ling, Shijie Na, Bingbo Lv, Baoxin Ren, Liqun Jiao, Zhangsheng Yu, Lei Huang, Jun Shi, Qian Sun, Gongjian Guo, Qianhui Yuan, Runzhi Ma, Xuehui Cao, Hongxin Xu, Qiming Chen, Ye Wang, Chaoqing Sun, Na Li, Yuanyuan Liu, Tingting Xie, Zhuo Feng, Lin Pan, Wenyi Wu, Siyu Weng, Yuanyuan Wang, Xiaoqian Chu, Xinyue Chen, Tao Shen, Yun Long, Tingting Wang, Miao Fang, Weiwen Tang, Cengceng Shang · 发表于：JAMA Network Open · 年份：2026 · DOI：10.1001/jamanetworkopen.2026.1929 · 被引用次数：3 · 研究领域：Vascular Procedures and Complications、Central Venous Catheters and Hemodialysis、Peripheral Artery Disease Management

Importance: Transradial access (TRA) has emerged as a promising alternative to standard transfemoral access (TFA) for interventional cardiac procedures, but its application for examination of the cerebral circulation has not been tested in a clinical trial. Objective: To compare the efficacy and safety of TRA with TFA for diagnostic cerebral angiography. Design, Setting, and Participants: This investigator-initiated, multicenter, open-label, noninferiority randomized clinical trial with a blinded outcome assessment was conducted at 13 sites in China. Patients eligible for cerebral angiography were randomized between September 15, 2023, and November 4, 2024, with final follow-up performed on November 27, 2024. The primary analysis was performed in the intention-to-treat population; secondary analyses were performed in the per-protocol population. Interventions: Patients were randomly allocated to TRA (n = 431) or TFA (n = 430) for diagnostic cerebral angiography. Main Outcomes and Measures: The primary outcome was the success of diagnostic cerebral angiography. Secondary outcomes were success in achieving an accurate diagnosis, duration of angiography and fluoroscopy, time in bed, and patient-reported satisfaction on an 11-point visual analog scale for pain (ranging from 0 [none] to 10 [worst possible]) within 24 hours after the procedure. The noninferiority margin was an absolute difference of 5% in success of angiographic diagnosis and success of accurate diagnosis. Results:...