Background Radial artery occlusion is an infrequent complication of transradial catheterization. Assessment of radial artery occlusion is a critical aspect of clinical care, and it should be done with an additional test, commonly by a plethysmographic test (reverse Barbeau test) or ultrasound (Doppler), the last is the gold standard. The objective of this study was to evaluate the accuracy of the reverse Barbeau test in detecting radial artery occlusion after transradial catheterization. Methods A study carried out in two centers encompassing patients submitted to procedures by radial access. All patients received at least 5,000IU of heparin. Sheaths were immediately removed after the procedure, using a patent hemostasis protocol. Patency of the radial artery was verified by reverse Barbeau test and duplex Doppler evaluation within the first 24 hours. Results A total of 350 patients were enrolled, with a mean age of 61.7 (±9.7) years. Radial artery occlusion was verified after the procedure in 19 (5.4%) patients, using duplex Doppler scan. Application of reverse Barbeau test had the following results: 64.0% type A curve, 15.7% type B, 8.3% type C, and 12.0% type D (the last suggesting occlusion). With reverse Barbeau test, patients with confirmed occlusion by ultrasound evaluation, 21.1% would be missed by a false-negative test, and in the ones, without radial artery occlusion, 8.2% would be misdiagnosed as having it (sensibility 78.9%; specificity 91.8%). Conclusion Reverse Barbeau test has good accuracy to detect radial artery occlusion, and it is a good option for clinical day use, although using reverse Barbeau test results in the overestimation of radial artery occlusion.

Background: The radial approach has been increasingly used worldwide for diagnostic and therapeutic cardiac catheterization. The radial artery caliber is one of the limitations of its use. The objective of this study was to describe the anatomy of the radial and ulnar arteries, as well as to develop a radial artery diameter prediction score using clinical and anthropometric criteria. Methods: Using vascular ultrasound with bilateral radial and ulnar artery measurements, 1,180 patients who underwent cardiac catheterization or angioplasty procedures were prospectively evaluated. Using the patients' variables, a radial artery diameter prediction score was developed in a cross-sectional fashion, using half of the sample. The score was validated with the half not used for deriving the model. Results: A total of 1,180 patients were evaluated. The mean internal diameter of the right and left radial arteries was 2.69±0.69mm and 2.53±0.64mm (p<0.01), and the mean internal diameter of the right and left ulnar arteries was 2.09±0.59mm and 2.10±0.60mm (p=0.76), respectively. The factors that positively correlated with arterial size were male sex, previous catheterization, height, weight, and body surface area. The risk score developed using clinical and anthropometric variables had unsatisfactory discriminatory capacity (c-statistics 0.64). Conclusion: The right radial artery is the largest forearm artery in most cases. Men and patients who had previously undergone catheterization have a larger mean radial artery diameter. The artery diameter prediction score has modest accuracy for clinical use. RESUMO -Introdução:A via de acesso transradial tem crescido em utilização mundialmente para cateterismo cardíaco diagnóstico e terapêutico. O calibre da artéria radial é um dos limitadores de seu uso. O objetivo deste estudo foi descrever a anatomia das artérias radiais e ulnares, bem como desenvolver um escore de predição de diâmetro da artéria radial, utilizando critérios clínicos e antropométricos. Métodos: Usando ultrassonografia vascular, com mensuração de artérias radiais e ulnares, bilateralmente, foram prospectivamente avaliados 1.180 pacientes, que foram submetidos a procedimentos de cateterismo cardíaco ou angioplastia. Usando as variáveis dos pacientes, foi transversalmente elaborado um escore de predição de diâmetro de artéria radial, utilizando-se metade da amostra. O escore foi validado com a metade da população não utilizada para a formulação do escore. Resultados: Foram avaliados 1.180 pacientes. O diâmetro interno médio das artérias radiais direita e esquerda foram 2,69±0,69mm e 2,53±0,64mm (p<0,01), e das artérias ulnares direita e esquerda foram 2,09±0,59mm e 2,10±0,60mm (p=0,76). Os fatores que se correlacionaram positivamente com o tamanho arterial foram sexo masculino, cateterismo prévio, altura, peso e área de superfície corporal. O escore de risco desenvolvido utilizando variáveis clínicas e antropométricas teve capacidade discriminatória não satisfatória (estatística-c 0,64). Conclusão: A artéria radial dire...