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The transradial approach is recommended as a first choice in coronary catheterizations and interventions, for among other reasons, the reduction in the number of local complications. A head-to-head comparison of the reverse Barbeau test (RBT) and duplex ultrasonography (DUSG) for the detection of post-procedural radial artery patency and occlusion has not yet been evaluated. In 500 patients from our same-day discharge program (age 65 ± 9.4 years, 148 women), radial artery patency and occlusion, compression time, haematomas, and other local complications were evaluated. Radial artery patency was confirmed in 495 patients (99.0%), and complete radial artery occlusion (RAO) was detected in 2 (0.4%) patients using both methods. In 3 patients (0.6%), the RBT was negative, while incomplete RAO was detected by DUSG. Superficial haematomas (˃ 5 but ≤10 cm) were found in 27 (5.4%) patients. There were no other local complications. Detection of radial artery patency and occlusion using the RBT and DUSG was comparable. The incidence of RAO in our study was extremely low. Thanks to its simplicity, the RBT has the potential to be used as the first method of detection of radial occlusion after coronary catheterizations.

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After transradial primary percutaneous coronary intervention, early patent hemostasis and short artery compression times were associated with a higher incidence of local hematomas. The incidence of hematomas was dependent on the use of abciximab, but unrelated to the type of P2Y12 inhibitor used. All hematomas were without clinical consequences.

IntroductionPeriprocedural bleeding related to coronary angiography (CAG) or percutaneous coronary intervention (PCI) is associated with worse prognosis. Determining genetic variations associated with increased bleeding risk may help to identify high-risk patients.AimTo analyse the association between single nucleotide polymorphisms (SNPs) of crucial haemostatic platelet receptors (GPIa, GPVI, P2Y12) and the risk of periprocedural bleeding complications related to CAG/PCI.Material and methodsThe population consisted of 73 patients with ischaemic heart disease who developed bleeding complications within 30 days after CAG/PCI and 331 patients without bleeding. The frequency of SNPs of GPIa 807C/T, GPVI 13254T/C, P2Y12 32C/T, and P2Y12 H1/H2 haplotype was analysed using polymerase chain reaction (PCR) hybridization methods.ResultsThe prevalence of variant alleles GPIa 807T, GPVI 13254C, P2Y12 34T, and P2Y12 H2 haplotype in the total study population was 56.7%, 20.3%, 56.2%, and 24.3%, respectively. The presence of variant alleles was not related to increased risk of periprocedural bleeding: GPIa 807C/T (OR = 1.29, 95% CI: 0.75–2.24, p = 0.334), GPVI 12354T/C (OR = 0.82, 95% CI: 0.40–1.64, p = 0.551), P2Y12 34C/T (OR = 0.71, 95% CI: 0.42–1.22, p = 0.189), P2Y12 H1/H2 haplotype (OR = 0.69, 95% CI: 0.35–1.36, p = 0.258). The frequency of the homozygous form of P2Y12 H2 haplotype was higher in the group of patients who developed bleeding (OR = 2.79, 95% CI: 0.51–13.77, p = 0.161).ConclusionsNo significant association of the SNPs of GPIa 807C/T, GPVI 13254T/C, P2Y12 32C/T, and P2Y12 H1/H2 haplotype with increased risk of periprocedural bleeding was found in patients with ischaemic heart disease undergoing CAG/PCI.

Background: To compare the number of severe periprocedural bleeding complications from the total number of bleeding complications associated with diagnostic selective coronary angiography or percutaneous coronary intervention (PCI) when using different classifications (TIMI, GUSTO, PLATO, BARC) (TIMI 9.4%, GUSTO 15.1%, PLATO 39.2% and BARC 35.9%). The power of association between severe bleeding determined by these classifications and real hemodynamic compromise using (Cardiol J 2015; 22, 6: 665-674)

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