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Distal transradial artery access for coronary angiography in a patient having rheumatoid arthritis-related severe arthropathies
  1. Nasir Rahman,
  2. Ihsan Ullah,
  3. Awais Farhad and
  4. Ghufran Adnan
  1. Cardiology, The Aga Khan University Hospital Main Campus Karachi, Karachi, Pakistan
  1. Correspondence to Dr Nasir Rahman; nasir.rahman{at}


Conventional radial access has become the default access for coronary angiography. Sometime, it is difficult to take a conventional radial access, especially in patients having severe arthropathies leading to limited wrist joint mobility. In such scenarios, distal transradial access (dTRA) can be adopted. We describe a case of an elderly male patient having rheumatoid arthritis with arthropathies. He presented to us with unstable angina; coronary angiogram was advised for ischaemia assessment. Right dTRA was adopted due to severe joint deformity at wrist joint, limiting joint extension. A successful coronary angiogram was performed via the right dTRA without major discomfort and complications. Haemostasis was secured with TR band radial artery compression device. In this case report, we have evaluated the importance of practising dTRA in a patient with severe arthropathies.

  • interventional cardiology
  • ischaemic heart disease
  • rheumatoid arthritis

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  • Contributors NR contributed in the conception, drafting, critical review and final approval of the study to be published. IU wrote the manuscript. AF and GA contributed in the writing, reviewing and design of the work.

  • Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

  • Competing interests None declared.

  • Provenance and peer review Not commissioned; externally peer reviewed.