In this context, prophylactic and reparative cardiovascular interventional measures using angioplasty and catheterization techniques are necessary. Thus, the use of the radial artery as an access route for diagnostic procedures in cardiology was first described in the literature by Lucien Campeau in 1989 [2]. Afterward, Kiemeneij published the first three patients submitted to angioplasty with stenting by this route [3]. Then, in 1997, the same author published the ACCESS study [4], comparing the coronary intervention of the radial, brachial, and femoral accesses. As the main clinical outcomes of the use of the radial artery route, an important reduction in hemorrhagic complications were found. In addition, this safety profile has also been demonstrated in patients with acute coronary syndromes [4].

Therefore, the access by transradial approach (TRA) is consolidated through studies that show a positive association between this path and the reduction in cardiac mortality, mediated by a lower rate of vascular complications, including in patients undergoing primary and primary angioplasty. rescue [5-8]. As scientific evidence of this, a retrospective analysis of the British Columbia Database of cardiac and renal records showed that progression to chronic renal failure after six months of cardiac catheterization occurred in 0.2% of those who underwent the TRA procedure [9].

In this sense, the distal transradial approach (dTRA) was advocated to reduce the risk of occlusion of the radial artery in the forearm, preventing reintervention through the same access site and complications at the bleeding and vascular site [10,11]. In addition, dTRA is also the main site for retrograde recanalization of radial artery occlusion. According to Kaledin et al., The flow of anterograde blood would be preserved through the superficial palmar arch (snuffbox), thus, the risk of thrombosis and occlusion of the extensive radial artery in the forearm would be minimized [12]. In addition, this arterial entry is beyond the forearm compartments, reducing the risk of compartment syndrome. Finally, the dTRA provides better operator and patient comfort, especially when using the left radial approach (ldTRA) [12].

Therefore, the present study aimed to carry out a systematic review of the main considerations of prophylactic and reparative cardiovascular interventional procedures through the distal transradial approach in the anatomical snuffbox.