Case report: Chronic radial artery occlusion treated with paclitaxel-coated balloon via distal transradial access

Abstract

A 38-year-old male patient was diagnosed as acute non-ST-segment elevation myocardial infarction on Apr 21st 2021 and he received percutaneous transluminal coronary angioplasty for RCA via transradial artery access. He sought for second percutaneous coronary intervention in our center for frequently exertional angina on Sep 13th 2021. Proximal right radial artery pulsation can not be touched in physical examination, indicating right radial artery occlusion (RAO). Distal transradial access was applied and RAO was confirmed via angiography. With balloon pre-dilation, the guidewire and guiding catheter crossed the occlusion and coronary intervention was successfully completed. A Reewarm 2.5 × 220 mm paclitaxel drug-coated balloon (Endovastec, China) was released at 12 atm in radial arterial lesion with 90 s. Pulsation of radial artery can be well palpated 24 h after PCI. No oral anticoagulant was added. The right radial artery remained patent after 8-month and 14-month follow-up and there was no abnormal sensation or obstacle of right hand.

Protocol for a Single-Center Randomized Controlled Trial of Percutaneous Coronary Intervention Via Distal Transradial Access Versus Transradial Access

“…Clinical studies have shown that dTRA, compared with TRA, significantly decreases the incidence of RAO 24 hours and 30 days after coronary operation. Subgroup analysis has suggested that dTRA is feasible for PCI of single-vessel, double-vessel, and left main coronary artery disease, and that dTRA is also feasible for coronary artery disease intervention [2,[7][8][9][10]. Although some retrospective studies have been conducted, the safety and effectiveness of dTRA for coronary artery disease intervention in China have not been further confirmed in randomized controlled trials.…”