Low rate of access site complications after transradial coronary catheterization: A prospective ultrasound study

Mattea, Violeta; Salomon, C; Menck, Niels; Lauten, Philipp; Malur, Frank Michael; Schade, Anja; Steinborn, Frank; Costello-Boerrigter, Lisa C.; Neumeister, Axel; Lapp, Harald

doi:10.1016/j.ijcha.2016.12.003

Cited by 17 publications

(13 citation statements)

References 29 publications

(55 reference statements)

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“…Similar to our study, multiple puncture attempts for radial artery access are reported to increase vascular injury and radial artery spasm, which leads to radial artery thrombosis (31,32). Prior studies have also reported that the incidence of RAO progressively increased with sheath size, although results were not consistent in all the studies (3,9,10,21,22,26,31,33,34). Furthermore, Rashid et al (13), in a meta-analysis, have evaluated the effect of sheath size among 19 studies, and the incidence of RAO ranged from nil to 19.5% according to used sheath size (0%, 2%, 11%, and 19.5%, respectively, for sheath size of 4F, 5F, 6F, and 7F, respectively).…”

Section: Discussionsupporting

confidence: 63%

Factors influencing radial artery occlusion after transradial coronary intervention in the Indian population

Dwivedi¹,

Sharma²,

Nayak³

et al. 2022

The Anatolian Journal of Cardiology

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Transfemoral vascular access is the most common approach for both diagnostic as well as therapeutic coronary interventions; however, higher rate of vascular complications and bleeding have been reported especially in women and older patients than with radial access (1). Transradial approach (TRA) is now being increasingly used and is the preferred vascular access for cardiac interventions (2). TRA offers advantages such as minimal invasion, ease of performance of diagnostic and therapeutic coronary interventions, minimum patient discomfort, early ambulation, shorter hospital stay, and lower hospital costs (3-7). In addition, there are lower local site complications, morbidity, and mortality in patients who specifically present with acute coronary syndromes (6, 7). Radial artery occlusion (RAO) is one of the most frequent complications of TRA that affects a sizeable proportion of patients (8, 9). Post transradial coronary intervention (TCI), early RAO may occur because of radial artery spasm and thrombosis, which may be precipitated by combined effects of catheter-induced endothelial injury and decrease in blood flow after sheath and catheter insertion (8). The incidence of RAO varies in different studies ranging from 1% to 42%, and has been determined by the timing of evaluation and the method used for the diagnosis of RAO. Various patient-specific and procedure-related factors influence the occurrence and consequences of . However, the predictors of RAO after TCI are not clearly defined. In this study, we determine the incidence and patient-specific and procedure-related predictors of RAO among patients undergoing TCI.

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Section: Discussionsupporting

confidence: 63%

Factors influencing radial artery occlusion after transradial coronary intervention in the Indian population

Dwivedi¹,

Sharma²,

Nayak³

et al. 2022

The Anatolian Journal of Cardiology

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“…The RA is a small-sized artery whose diameter ranges from 1.15 to 3.95 mm (8). Smaller RADs have been associated with vascular complications (9,10). Multiple puncture attempts increase the risk of vasospasm and may result in hemorrhage, dissection, pseudoaneurysm, thrombosis and pain.…”

Section: Introductionmentioning

confidence: 99%

Effect of transient ulnar artery compression on radial artery diameter

Yılmaztepe

Yılmaz

2018

Exp Ther Med

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The transradial approach is widely preferred in coronary procedures. A small radial artery diameter (RAD) is the most important factor affecting successful access. Various maneuvers and medications have been used to increase the RAD and thereby facilitate RA cannulation. Ulnar artery compression (UAC) for 30 min has been indicated to be effective in increasing the RAD and facilitating RA access. The aim of the present preliminary study was to assess the effect of transient UAC for 1 min on the RAD. A total of 151 patients were included in the present study. RA ultrasonography was performed at the level of the wrist. The UA was compressed for 1 min. The RAD was measured at baseline, at the end of UAC and at 1 min thereafter. The results indicated that the RAD was significantly smaller in diabetic vs. non-diabetic patients (2.35±0.43 vs. 2.50±0.39 mm, P=0.024) and in women vs. men (2.25±0.38 vs. 2.56±0.38 mm, P<0.001). At the end of UAC, the RAD was increased compared with that at baseline (2.45±0.41 vs. 2.62±0.41 mm, P<0.001), but it started to decrease thereafter, and the RAD measured at 1 min after stopping UAC was significantly smaller (2.62±0.41 vs. 2.55±0.40 mm, P<0.001), while remaining significantly larger than that at baseline (P<0.001). The RA peak systolic flow velocity also increased significantly during UAC (35.3±8.9 vs. 60.3±19.2 cm/sec; P<0.001). In conclusion, Transient UAC for 1 min significantly increased the RAD and the peak systolic flow velocity. Further studies with clinical endpoints are required for further exploration of the feasibility of this approach.

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“…However, the radial artery (RA) is smaller than the femoral artery[ 3 ], and TRA is associated with a higher prevalence of acute injuries and chronic intimal changes [ 7 , 8 ]. RA occlusions rate is usually low and remain mostly asymptomatic [ 9 ]. Previous studies investigated qualitative RA vessel wall changes after TRC in a non-serial manner.…”

Section: Introductionmentioning

confidence: 99%

Radial artery neointimal hyperplasia after transradial PCI—Serial optical coherence tomography volumetric study

et al. 2017

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AimsTransradial catheterization (TRC) is a dominant access site for coronary catheterization and percutaneous coronary interventions (PCI) in many centers. Previous studies reported higher intimal thickness of the radial artery (RA) wall in patients with a previous history of TRC. In this investigation the aim was to assess the intimal changes of RA using the optical coherence tomography (OCT) intravascular imaging in a serial manner.Methods and results100 patients with the diagnosis of non-ST-elevation myocardial infarction (nSTEMI) treated by PCI were enrolled (6 patients were excluded from this analysis because of occluded RA at follow-up [2 patients] and insufficient quality of OCT images [4 patients]). An 54mm long OCT run of the RA was performed immediately after the index PCI and repeated 9 months later. Volumetric analyses of the intimal layer and lumen changes were conducted. Median intimal volume at baseline versus 9 months was 33.9mm3 (19.0; 69.4) versus 39.0mm3 (21.7; 72.6) (p<0.001); and median arterial lumen volume was 356.3mm3 (227.8; 645.3) versus 304.7mm3 (186.1; 582.7) (p<0.001). There was no significant difference in the effect of any clinical factor on the RA volume changes.ConclusionsOCT volumetric analyses at baseline and 9 months showed a significant increase in the radial artery intimal layer volume and a decrease in lumen volume after transradial PCI. No significant factors affecting this process were identified.

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Low rate of access site complications after transradial coronary catheterization: A prospective ultrasound study

Cited by 17 publications

References 29 publications

Factors influencing radial artery occlusion after transradial coronary intervention in the Indian population

Factors influencing radial artery occlusion after transradial coronary intervention in the Indian population

Effect of transient ulnar artery compression on radial artery diameter

Radial artery neointimal hyperplasia after transradial PCI—Serial optical coherence tomography volumetric study

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