Learning curve in the use of the radial artery as vascular access in the performance of percutaneous transluminal coronary angioplasty

Abstract

Radial artery access for coronary artery angioplasty is a cost‐effective alternative to other vascular entry sites. The initial series of patients using the radial artery site for an operator without experience in using arm access for coronary artery angioplasty was evaluated. Clinical success was achieved via the radial artery in 87% of 32 lesions and 84% of 27 patients. The major feature limiting success via the arm was radial/brachial artery spasm, which occurred in 30% of cases (clinical success: 50% with spasm vs. 95% without spasm, P < 0.05). Spasm was more common in patients with peripheral vascular disease and in hypertensive patients not treated with calcium channel blockers prior to angioplasty. Coronary angioplasty via the radial artery may be successfully performed even by the interventionalist inexperienced in arm access. Vascular spasm is an important feature that limits the ability successfully to complete coronary angioplasty via the radial artery. Cathet. Cardiovasc. Diagn. 44:147‐152, 1998. © 1998 Wiley‐Liss, Inc.

Comparison of fluoroscopy time during coronary angiography and interventions by radial and femoral routes- can we decrease the fluoroscopy time with increased experience? An observational study

“…However, concerns have been raised about prolonged procedure time and increased radiation exposure to the operators by using radial route of access (4)(5)(6). Although, some studies have shown that with increasing operator experience radiation exposure can be minimized with transradial approach (TRA) and hence majority of radial operators assume that special radiation exposure precautions are unnecessary (7,8). On the contrary, few other studies demonstrated increased fluoroscopy time and radiation exposure with radial access and advocated special radiation protection methods to reduce operator radiation exposure (9,10).…”

Comparision of Various Vasodilators Regimen During Radial Corornary Angiogram: A Prospective Randomised Trial

“…17 Many studies done in the past have used different spasmolytic regimens. 5,8,9,16 In one of the similar studies publish by Kiemeneij et al 14 which was a prospective study proved that intra-arterial administration of 5 mg of verapamil and 200 mcg of nitroglycerin reduced the occurrence and severity of radial artery spasm. The data showed the evidence of benefit of verapamil in the prevention of spasm but concern still remains regarding the negative inotropic and chronotropic effects of verapamil.…”

“…The prevention of spasm is easy than to control when it occurs. 8 He and yang classification classifies the radial artery into type III artery graft with high propensity for spasm and also as stated above due to abundance of the alpha receptors slight cathecholamine release during pain or anxiety can induce radial spasm. 17 Many studies done in the past have used different spasmolytic regimens.…”

“…The problem which are faced are unsuccessful radial access, coronary catheterization failure, pulse deficit, radial artery occlusion, dissection, and spasm. 1,3,7,8,9 The most common of these is the radial spasm 8,9 causing patient discomfort and even procedure failure. There is high propensity of spasm in the radial artery because of its anatomic property.…”

Coronariografia via transradial: curva de aprendizagem, avaliada por estudo multicêntrico

“…A deambulação precoce, permitida pelo acesso radial, produz maior conforto e reduz os custos da hospitalização [4][5][6] . No entanto, o acesso transradial é algumas vezes tecnicamente mais trabalhoso e delicado, demandando maior período de aprendizagem para os operadores [7][8][9] .…”