Comparison of long-term radial artery occlusion following trans-radial coronary intervention using 6-french versus 7-french sheaths

Abstract

Background: The aim of this study was to explore the impact of 6-Fr and 7-Fr sheaths on the incidence of long-term radial artery occlusion (RAO) after trans-radial coronary intervention (TRI). , patients with ischemic heart disease including acute myocardial infarction and true bifurcation lesions were randomly assigned to 6-Fr group and 7-Fr group immediately after coronary angiography in a 1:1 ratio. The radial artery diameters were observed by ultrasound examination one day prior to TRI as well as at 30 days and 1 year after TRI. The primary endpoint was the incidence of RAO at 1-year after TRI. The secondary endpoints were the incidence of local vascular complications during hospitalization and changes of radial artery diameters within 1-year after TRI between the two groups. Additionally, multivariate logistic regression analysis was used to explore potential factors related to the incidence of long-term RAO after TRI. Results: A total of 214 patients were enrolled and randomly assigned to 6-Fr group (n = 105) or 7-Fr group (n = 109). There was no significant difference in the incidence of RAO at 1-year after TRI (8.57% vs. 12.84%, p = 0.313). Moreover, no significant difference was observed in the incidence of local vascular complications during hospitalization (20% vs. 24.77%, p = 0.403). After 1-year follow-up, no significant difference was found in radial artery diameters (2.63 ± 0.31 mm vs. 2.64 ± 0.27 mm, p = 0.802). Multivariate logistic analysis revealed that repeated TRI was an independent risk factor of long-term RAO 1 year after TRI (OR = 10.316,, p = 0.001). Conclusions: Compared to 6-Fr sheath, 7-Fr sheath did not increase short-term or long-term incidence of RAO after TRI. (Cardiol J XXXX; XX, X: xx-xx)

2 bladder, or not 2 bladder? That is the question

“…From this, the authors conclude that using the two‐bladder band, operators can safely use larger sheaths for complex interventions without increasing RAO rates. However, a similar finding was reported previously with conventional patent hemostasis technique (without ulnar compression) 5 . Thus, the equivalent rates of RAO for 6 French versus 7 French sheaths may not be attributable or unique to the two‐bladder band.…”

“…However, a similar finding was reported previously with conventional patent hemostasis technique (without ulnar compression). 5 Thus, the equivalent rates of RAO for 6 French versus 7 French sheaths may not be attributable or unique to the two-bladder band.…”

Effect of Thin-Walled Radial Sheath for Large-Bore Access On Reducing Periprocedural Radial Artery Occlusion Following Complex PCI: The REDUCE-RAO Randomized Trial

“…In a Japanese study using Ultrasound Doppler assessment of the radial artery, the S/A ratio >1 was associated with lower blood flow in radial artery after TRI, but the association with RAO has not been confirmed [28]. In addition, Fan et al [16] found that the 7-Fr sheaths were related with a greater incidence of RAO in 248 participants randomized to 6-Fr or 7-Fr sheaths (5.71% vs. 7.34%, p < 0.01). In our study, multivariate regression analysis showed that several baseline characteristics associated with an increased risk of RAO, such as lower BMI, peripheral artery disease and higher S/A value.…”

Early radial artery occlusion following the use of a transradial 7‐French sheath for complex coronary interventions in Chinese patients

“…32 Recently, a randomized controlled clinical trial compared the impact of 6-Fr and 7-Fr sheaths on the incidence of long-term RAO, and found that there was a non-significant difference in the incidence of RAO at 1-year after TRI (8.57% vs. 12.84%, p = .313). 33 Preventing RAO is of utmost clinical importance and should be a central consideration. 6,7,34 It is important to note that the RAO rate is dependent on the timing of the evaluation, with significantly higher rates for earlier assessments than for later assessments (generally at 1 month).…”

“…In a small singlecenter randomized trial, Fan et al showed that compared to 6-Fr sheath, 7-Fr sheath did not increase short-term or long-term incidence of RAO after TRI in patients with ischemic heart disease including acute myocardial infarction and true bifurcation lesions. 33 The rate of radial artery occlusion between the 7-Fr Glidesheath Slender (Terumo, Japan)…”