Gender differences in the distal radial artery diameter for the snuffbox approach

Cardiol J. 2018;25(5):639-641. doi: 10.5603/CJ.2018.0128.


Background: Recently, interventional cardiologists have been increasingly interested in snuffbox approach for coronary angiography (CAG) and percutaneous coronary intervention (PCI). However, there is lack of data regarding distal radial artery (RA) diameter according to gender. Therefore, the aim herein was to investigate gender differences in the diameter of distal RA diameter.

Methods: Left snuffbox approach was done in 117 patients who had planned CAG or PCI for suspected myocardial ischemia between 1 December 2017 and 28 February 2018 at the Chonnam National University Hospital, Gwangju, Korea. Left RA angiography was achieved from 101 patients. Among 101 individuals, 69 (68.3%) men and 32 (31.7%) women were enrolled. There was no significant difference in systolic and diastolic blood pressure, body mass index, left ventricular systolic function, or patients with acute coronary syndrome in either group.

Results: The average diameter of distal RA was 2.57 mm in all patients. Women had a significantly smaller diameter of distal RA than men (2.40 mm vs. 2.65 mm, p = 0.016). Nevertheless, CAG via snuffbox approach by 6 Fr sheath was successfully performed in all 117 patients. Regarding success rate of the distal RA approach, women had a lower success rate (32/38) compared with men (72/79), but not significantly (84.2% vs. 91.1%, p = 0.264).

Conclusions: Females has a significantly smaller distal RA diameter compared to males. Moreover, the success rate of the distal RA approach tends to be higher in men than in women.

Keywords: coronary angiography; distal radial artery; percutaneous coronary intervention; snuffbox approach.

Publication types

  • Comparative Study

MeSH terms

  • Acute Coronary Syndrome / diagnosis*
  • Acute Coronary Syndrome / surgery
  • Aged
  • Catheterization, Peripheral / methods*
  • Coronary Angiography / methods*
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention / methods*
  • Radial Artery / anatomy & histology*
  • Retrospective Studies
  • Sex Factors