Radial Artery Access Complications: Prevention, Diagnosis and Management

Roy, Soma; Kabach, Mohamad; Patel, Dhavalkumar; Guzmán, Luis A.; Jovin, Ion S.

doi:10.1016/j.carrev.2021.12.007

Cited by 18 publications

(10 citation statements)

References 67 publications

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“…[24][25][26] Despite the use of special hydrophilic sheaths and catheters, as well as the increased use of delicate or assisted-tracking techniques, increased operator experience, and periprocedural use of vasodilator and anticoagulant medications, radial artery complications are still frequently encountered. 27,28 RAS is the most common handicap of TRA and occasionally causes procedural failure. 23 Because the radial artery has a small diameter and is mainly controlled by the α1-adrenergic nerves, its vasoreactivity is high, making it susceptible to vasospasm in response to trauma.…”

Section: Discussionmentioning

confidence: 99%

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Effect of Hand Dominance on Radial Artery Spasm and Occlusion: A Prospective Observational Study

et al. 2023

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Transradial access has become the most commonly used method for cardiac catheterization. Many medical and technical applications have been proposed to reduce TRA complications. The aim of this study is to examine the effect of hand dominance on radial artery spasm and radial artery occlusionin subjects undergoing CC via TRA. Between April 2020 and August 2022, 1713 subjects who underwent CC via TRA were included in the study. Patient data were obtained in terms of hand dominance of the catheterized side and RAS and RAO during a 1-month follow-up period. RAS was seen in 9.6% of the subjects. The RAS in patients catheterized by the dominant hand was significantly higher than that performed by the non-dominant hand (12 vs 7.8%; P = .004). RAO was seen in 1% of the subjects. RAO was significantly higher in the spasm side than in the no-spasm side (3 vs .8%; P = .009). Hand dominance was determined as an independent predictor of radial artery spasm (P = .006). In our study, RAS and RAO were more common on the dominant hand side than on the non-dominant side. Choosing the non-dominant hand for TRA for CC may reduce the incidence of RAS and RAO.

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Section: Discussionmentioning

confidence: 99%

“…24–26 Despite the use of special hydrophilic sheaths and catheters, as well as the increased use of delicate or assisted-tracking techniques, increased operator experience, and periprocedural use of vasodilator and anticoagulant medications, radial artery complications are still frequently encountered. 27,28…”

Section: Discussionmentioning

confidence: 99%

Effect of Hand Dominance on Radial Artery Spasm and Occlusion: A Prospective Observational Study

et al. 2023

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“…Radial artery avulsion, compartment syndrome, and upper limb ischemia are the more serious complications. [9,10]…”

Section: Radial Accessmentioning

confidence: 99%

Complications of PCI and its Management

Mahilmaran

2023

IJCDW

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Contemporary percutaneous coronary intervention (PCI) has few complications and enhanced safety on one hand and on the other hand, available modern tools have enabled interventional cardiologists to venture into more complex patient subsets and fresh challenges in tackling the ensuing newer complications. Individual operators may take several years of experience before being exposed to the complications and hence, it is important to learn from the collective experience on the detection and management of these complications and better equipped to handle them when the need arises. The complications of PCI can be access related or coronary intervention related. The common acute coronary complications include abrupt vessel closure, thrombus, slow flow, dissection, perforation, stent dislodgement, and guidewire fracture and embolization. The chronic complications include late stent thrombosis, in-stent restenosis, and aneurysm formation. The use of imaging, physiology, and plaque modification tools are associated with specific complications which need to be kept in mind while using them. The successful management of complications needs prompt recognition, involving help from others and continued team effort and vigilance.

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“…In anesthesiology,the radial artery is the most commonly used site for arterial puncture placement because it is super cially located and the radial artery has collateral circulation and a low incidence of ischemic complications, radial artery cannulation may be the rst choice for arterial cannulation.Before radial artery cannulation,the ulnar artery collateral circulation should rst be assessed by Allen's test or modi ed Allen's test as a rule [1]. Second, invasive arterial waveforms are used to calculate Stroke volume variation(SVV) and pulse pressure variation (PPV) are the main targets for uid volume measurement.The SVV and PPV help to evaluate the uid volume status of the patient and also help to re ect the rationality of uid management,and often become the main reference target of Goal directed uid therapy(GDFT) [2].However,there are still some risks associated with radial artery puncture,such as local hematoma,pseudoaneurysm,thrombus or embolism,and infection.Therefore,there is a need to improve the technique of radial artery cannulation [3,4].…”

Section: Introductionmentioning

confidence: 99%

Plan-do-check-act was applied to improve the first success rate of radial artery catheterization in anesthesiology residents

Zhang,

Zhao,

Bai

et al. 2023

Preprint

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Background:In the Department of Anesthesiology, radial artery puncture and catheterization is a basic skill for every doctor. Invasive arterial puncture directly measures the blood pressure value through the catheter, realizing real-time accurate monitoring of blood pressure fluctuation in critically ill patients, which provides the basis for clinical diagnosis and treatment; at the same time, part of the test specimen can be retained through the end of the invasive arterial catheter, which reduces the complications brought about by frequent blood collection and puncture. Therefore, we need to improve the success rate of the first attempt of radial artery catheterization in anesthesiology standardized training residents. Objective:Improving the success rate of first attempt radial artery cannulation in anesthesiology standardized training residents. Methods:Forty anesthesia residents undergoing standardized residency training at Sichuan Provincial People's Hospital from January to May 2023 were randomly divided into a control group and a PDCA group, with 20 residents in each group. The control group received standardized training with routine management and radial artery puncture and catheterization teaching; the PDCA group received training with PDCA cycle management and radial artery puncture and catheterization teaching. The success rate of the first attempt of radial artery cannulation, duration of radial artery cannulation, ultrasound use rate, whether the items were prepared with missing items and complication rate of the standardized training residents in the two groups were recorded and analyzed. Results:One resident physician in the PDCA group did not participate in the assessment due to illness, so a total of 19 physicians in the PDCA group participated in the assessment, and all 20 physicians from the control group participated in the assessment.The first success rate of puncture in the PDCA group was 85% (17/20), which was significantly higher than that of 45% (9/20) in the control group (P=0.003).The time of radial artery cannulation after PDCA was 0.92(0.63,2.73) min, which was significantly shorter than that of 3.84(2.87,5.65) min in the control group (Z=4.68, P<0.05).The ultrasound utilization rate in the PDCA group was 45% (9/20), which was significantly higher than the 15% (3/20) in the control group (P<0.05). There was no statistically significant difference in item preparation omissions, assessment scores, and complication rates in the PDCA group of residents in the operational assessment compared to the control group. Conclusion:PDCA management helps to increase the success rate of radial artery cannulation on the first attempt, shorten the time to puncture and place the cannula, increase the rate of complete preparation of items, as well as reduce the rate of complications.

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Radial Artery Access Complications: Prevention, Diagnosis and Management

Cited by 18 publications

References 67 publications

Effect of Hand Dominance on Radial Artery Spasm and Occlusion: A Prospective Observational Study

Effect of Hand Dominance on Radial Artery Spasm and Occlusion: A Prospective Observational Study

Complications of PCI and its Management

Plan-do-check-act was applied to improve the first success rate of radial artery catheterization in anesthesiology residents

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