IMR Press / RCM / Volume 23 / Issue 10 / DOI: 10.31083/j.rcm2310329
Open Access Original Research
Effect of Thin-Walled Radial Sheath for Large-Bore Access On Reducing Periprocedural Radial Artery Occlusion Following Complex PCI: The REDUCE-RAO Randomized Trial
Hao Wang1,2,†Hao-Yu Wang1,2,†Shao-Yu Wu1,2,†Dong Yin1,2Lei Feng1,2Wei-Hua Song1,2Hong-Jian Wang1,2Cheng-Gang Zhu1,2,*Ke-Fei Dou1,2,*
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1 Department of Cardiology, Cardiometabolic Medicine Center, Coronary Heart Disease Center, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College, 100037 Beijing, China
2 State Key Laboratory of Cardiovascular Disease, 10037 Beijing, China
*Correspondence:; (Ke-Fei Dou); (Cheng-Gang Zhu)
These authors contributed equally.
Academic Editor: Gianluca Rigatelli
Rev. Cardiovasc. Med. 2022, 23(10), 329;
Submitted: 3 May 2022 | Revised: 14 July 2022 | Accepted: 22 July 2022 | Published: 28 September 2022
Copyright: © 2022 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: Transradial artery (TRA) access for percutaneous coronary intervention (PCI) was associated with lower risks of major bleeding and vascular complications compared to transfemoral artery access. Use of large-bore (7-Fr) guiding catheters through TRA approach increased the likelihood of radial artery occlusion (RAO). This study aimed to investigate whether use of the thin-walled 7-Fr Glidesheath Slender, allowing PCI with large-caliber guiding catheters, is superior to standard 7-Fr Cordis sheath with respect to periprocedural RAO within 24 hours after transradial coronary intervention (TRI) in complex lesions. Methods: A prospective randomized, controlled, single-blinded (patient-blinded) trial was conducted, randomizing 504 patients with TRI for complex lesions to either 7-Fr Glidesheath Slender or conventional 7-Fr Cordis sheath. The primary outcome was defined as the incidence of periprocedural RAO with Doppler ultrasound during the first 24 hours after TRI. Results: The incidence of early RAO was 10.3% for 7-Fr Glidesheath Slender and 13.5% for conventional 7-Fr sheath (p = 0.271). The procedural success rate for Glidesheath Slender was 92.9% and for Cordis sheath was 93.7% (p = 0.722). There was no signficiant difference between treatment arms in terms of local hematoma and radial spasm, whereas use of the Glidesheath Slender was associated with significantly less pain during the procedure (numeric rating scale [NRS], 2.27 ± 0.75 vs. 2.45 ± 0.95, p = 0.017). The assessment of radial artery in ultrasound parameters after complex TRI was improved with Glidesheath Slender. Conclusions: Among patients with complex coronary lesions undergoing TRI, 7-Fr Glidesheath Slender was not superior to conventional 7-Fr in the prevention of periprocedural RAO within 24 hours following complex PCI, without reducing RAO occurrence. Clinical Trial Registration: NCT04748068.

7-Fr Glidesheath Slender
complex PCI
large bore
radial artery occlusion
transradial access
2021-I2M-1-008/Chinese Academy of Medical Sciences Innovation Fund for Medical Sciences (CIFMS)
2020-ZX29/Beijing Health Promotion Association
2020-ZX52/Beijing Health Promotion Association
2020-1-4032/Beijing Municipal Health Commission-Capital Health Development Research Project
2017-CCA-VG017/Chinese Cardiovascular Association-V.G fund
Fig. 1.
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