Radial artery anomalies in the Macedonian population during transradial angiography procedures

Abstract

Objective: To assess the incidence of arterial anomalies of the radial artery in the Macedonian population registered during transradial access (TRA) angiography procedures in a large series of patients. Background: Transradial angiography (TRA) is now the recommended access for percutaneous coronary intervention, but technically is a more challenging approach for angiography procedures mostly due to the anatomic anomalies on the radial artery, which may influence the success rate of transradial angiographic procedures. Methods: All consecutive 19292 patients from our Center, in the period from March 2011 until December 2014 were examined. Preprocedural radial artery angiography was performed in all patients. Clinical and procedure characteristics, type and incidence of vascular anatomy variants and access site complications were analyzed. Results: Anatomical variants were present in 1625 (8.8%) patients. The most frequent was high-bifurcating radial artery origin from the axillary and brachial arteries in 1017 (5.5%) patients, 227 (1.2%) had extreme radial artery tortuosity, 176 (0.95%) had a full radial loop, 32 (0.17%) with hypoplastic radial artery and 173 (0.9%) had tortuous brachial, subclavian and axillary arteries. Radial artery spasm was very common in patients with present radial artery anomalies. Conclusion: Radial artery anomalies are very common in the general population. Knowing the anatomy of the radial artery helps the interventional cardiologist in successfully planning and performing this procedure. Radial artery angiography is strongly encouraged in every patient before the begining of the transradial angiography procedures.

Benefit of routine preprocedural radial artery angiography in STEMI patients

“…According to our experience [10][11][12] and results from this observational study preprocedural RA angiography reduces overall procedural time and major access site bleeding complications. Also we noted a significant decrease in primary TRA access site crossover after introducing RA angiography.…”

Risk Factor Distribution and Long-Term Outcomes in Young Patients Undergoing Percutaneous Coronary Intervention in Macedonia

“…Pre-procedural retrograde radial arteriography was performed in all patients to define the radial artery anatomy from mid forearm to ulnobrachial anastomosis and to delineate ulnar artery anatomy as well, thus generating the access roadmap [6][7][8][9][10] .…”

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“…This step will help the operator to evaluate individual radial artery anatomy and its anomalies far better as well as to plan a quick strategy to overcome them, thus preventing unnecessary and possible radial artery damage (dissection, rupture etc.) and procedure prolongation [6].…”

“…Their incidence may vary according to the available literature, starting from 8,8% [7,6], 13,8% [2], up to 22,8% according to Valsecchi et al [3]. They can be reason for procedural failure in 1-5% of the patients even in experienced operators` hands [4,9].…”