Debate: Does the distal radial approach offer added value over the conventional radial approach? No, it does not

QUESTION: Are there anatomical reasons to propose distal radial access over conventional radial access? ANSWER: The answer is yes. The hand has 2 arterial arches: a superficial arch, formed by the ulnar artery and the distal radial artery under discussion here, and a deep arch, formed by the radial and ulnar arteries. It cannot be denied that access via superficial radial artery is useful due to its location in the anatomic snuffbox, over bones such as the scaphoid and trapezium, which make it easily compressible. This results in a 49% lower hemorrhage rate after use and a 49% lower rate of thrombosis1 compared with conventional radial access. Furthermore, in the presence of a superficial radial artery occlusion, either the radial or ulnar artery could later be used as an alternative access site. However, in my opinion, this access is more difficult to perform, with a longer learning curve and a higher puncture failure rate, which leads to a greater number of cases in which conversion to a different type of access (cross-over) is necessary. On the other hand, conventional radial access is available in the 2 hands, and both ulnar arteries are equally feasible for vascular access, with less tortuosity. Q.: What evidence...