Complications Following Transradial Cerebral Angiography : An Ultrasound Follow-Up Study

Abstract

ObjectiveThe feasibility and usefulness of transradial catheterization for coronary and neuro-intervention are well known. However, the anatomical change in the catheterized radial artery (RA) is not well understood. Herein, we present the results of ultrasonographic observation of the RA after routine transradial cerebral angiography (TRCA). MethodsPatients who underwent routine TRCA with pre- and post-procedure Doppler ultrasonography (DUS) of the catheterized RA were enrolled. We then recorded and retrospectively reviewed the diameter and any complicated features of the RA observed on DUS, and the factors associated with the diameter and complications were analyzed. ResultsA total of 223 TRCAs across 181 patients were enrolled in the current study. The mean RA diameter was 2.48 mm and was positively correlated with male gender (p<0.001) and hypertension (p<0.002). The median change in diameter after TRCA was less than 0.1 mm (range, -1.3 to 1.2 mm) and 90% of changes were between -0.8 and +0.7 mm. Across 228 procedures, there were 12 cases (5.3%) of intimal hyperplasia and 22 cases (9.6%) of asymptomatic local vascular complications found on DUS. Patients with abnormal findings on the first procedure had a smaller pre-procedural RA diameter than that of patients without findings (2.26 vs. 2.53 mm, p=0.0028). There was no significant difference in the incidence of abnormal findings for the first versus subsequent procedures (p=0.68). ConclusionDUS identified the pre- and post-procedural diameter and local complications of RA. Routine TRCA seems to be acceptable with regard to identifying local complications and changes in RA diameter.

Radial artery diameter: a comprehensive systematic review of anatomy

“…A systematic search resulted in 940 studies. After exclusions, 450 full-texts were screened resulting in 71 studies included in our meta-analysis with a total of 4886 patients 7 8 12–80. A PRISMA flowchart can be seen in online supplemental figure 1.…”

Subclavian artery stenting via bilateral radial artery access: Four case reports

“…The problem that needs to be addressed is how to deliver larger-diameter stents. In a Korean study, the radial artery diameter was 2.74 ± 0.41 mm in men and 2.26 ± 0.42 mm in women[ 12 ]. There is no problem matching the radial artery with an arterial sheath of 6F, with maximum inner diameter of 2.2 mm and outer diameter of 2.46 mm.…”

Incidence and Prognostic Factors of Radial Artery Occlusion in Transradial Coronary Catheterization

“…The gold standard diagnostic method is the radial artery ultrasound, which enables the evaluation of the blood flow in the radial artery, detection of any damage to the arterial wall, measurement of the artery’s diameter and diagnosis of any other complication. The most recent, more sophisticated and operator-independent diagnostic method that can evaluate radial artery perfusion following transradial catheterization is laser perfusion imaging (LPI), although it is not widely available and requires more specialized hardware and software than ultrasound [ 11 , 21 , 28 , 30 , 31 , 32 , 33 , 34 , 35 , 36 ].…”