Radial Artery Occlusion After Cardiac Catheterization: Significance, Risk Factors, and Management

Goswami, Rohan; Oliphant, Carrie S.; Youssef, Haidy; Morsy, Mohamed; Khouzam, Rami N.

doi:10.1016/j.cpcardiol.2016.09.002

Cited by 16 publications

(9 citation statements)

References 37 publications

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“…Nevertheless, we found very similar results in heavy smoker patients with substantial smoking histories. Although a crossover design was considered for the study investigating heavy smokers, it was discarded for ethical reasons (i.e., risk of arterial catheter thrombosis and radial artery vasospasm if the sessions were extended) (22). The healthy participants were carefully selected, and only those able to vape at high wattage were recruited; the majority of participants reported inhaling vapor directly into the lungs, without retaining it in the mouth (direct-to-lung inhalation).…”

Section: Discussionmentioning

confidence: 99%

Fourth generation e-cigarette vaping induces transient lung inflammation and gas exchange disturbances: results from two randomized clinical trials

Chaumont

Borne

Bernard

et al. 2019

American Journal of Physiology-Lung Cellular and Molecular Phys

115

109

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When heated by an electronic cigarette, propylene glycol and glycerol produce a nicotine-carrying-aerosol. This hygroscopic/hyperosmolar aerosol can deposit deep within the lung. Whether these deposits trigger local inflammation and disturb pulmonary gas exchanges is not known. The aim of this study was to assess the acute effects of high-wattage electronic cigarette vaping with or without nicotine on lung inflammation biomarkers, transcutaneous gas tensions, and pulmonary function tests in young and healthy tobacco smokers. Acute effects of vaping without nicotine on arterial blood gas tensions were also assessed in heavy smokers suspected of coronary artery disease. Using a single-blind within-subjects study design, 25 young tobacco smokers underwent three experimental sessions in random order: sham-vaping and vaping with and without nicotine at 60 W. Twenty heavy smokers were also exposed to sham-vaping ( n = 10) or vaping without nicotine ( n = 10) in an open-label, randomized parallel study. In the young tobacco smokers, compared with sham-vaping: 1) serum club cell protein-16 increased after vaping without nicotine (mean ± SE, −0.5 ± 0.2 vs. +1.1 ± 0.3 µg/l, P = 0.013) and vaping with nicotine (+1.2 ± 0.3 µg/l, P = 0.009); 2) transcutaneous oxygen tension decreased for 60 min after vaping without nicotine (nadir, −0.3 ± 1 vs. −15.3 ± 2.3 mmHg, P < 0.001) and for 80-min after vaping with nicotine (nadir, −19.6 ± 2.8 mmHg, P < 0.001). Compared with sham vaping, vaping without nicotine decreased arterial oxygen tension for 5 min in heavy-smoking patients (+5.4 ± 3.3 vs. −5.4 ± 1.9 mmHg, P = 0.012). Acute vaping of propylene glycol/glycerol aerosol at high wattage with or without nicotine induces airway epithelial injury and sustained decrement in transcutaneous oxygen tension in young tobacco smokers. Intense vaping conditions also transiently impair arterial oxygen tension in heavy smokers.

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Section: Discussionmentioning

confidence: 99%

Fourth generation e-cigarette vaping induces transient lung inflammation and gas exchange disturbances: results from two randomized clinical trials

Chaumont

Borne

Bernard

et al. 2019

American Journal of Physiology-Lung Cellular and Molecular Phys

115

109

View full text Add to dashboard Cite

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“…Previous studies have emphasized that the application of postoperative antiplatelet drugs is necessary to prevent RAO ( 30 , 31 ). At the 30-day follow-up on ultrasonography, our results also confirmed that dual-antiplatelet therapy could effectively reduce the RAO rate compared with single-antiplatelet therapy (4.0 vs. 1.8%, p = 0.001).…”

Section: Discussionmentioning

confidence: 99%

Different Antiplatelet Strategies for Radial Artery Protection After Transradial Coronary Angiography—A Prospective Observational Cohort Study

Zheng

Yang

Cheng

et al. 2022

Front. Cardiovasc. Med.

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IntroductionRadial artery occlusion (RAO) after transradial access is a common thrombotic complication. A meta-analysis has proven that RAO incidence in transradial coronary angiography (TRCA) settings was significantly higher than that in percutaneous coronary intervention settings. This prospective observational cohort aimed to evaluate radial artery protection after TRCA with different antiplatelet strategies.MethodsA total of 2,316 patients undergoing TRCA was enrolled and divided into two groups: single-antiplatelet and dual-antiplatelet groups. Radial artery patency was evaluated by ultrasound before, at 24 h, and 30 days after TRCA. The primary endpoint was RAO incidence at 30 days after TRCA.ResultsA total of 66 RAO was found on ultrasonography at 30-day follow-up (incidence: 2.8%). In the dual-antiplatelet group, the rate of RAO was significantly lower compared with the single-antiplatelet group (1.8 vs. 4.0%; odds ratio (OR): 0.41; 95% confidence interval (CI): 0.24–0.70; p = 0.001). The rate of self-recanalization in the dual-antiplatelet group was significantly higher than that in the single-antiplatelet group (73.68 vs. 44.12%, p < 0.001). However, there was no statistical difference in delayed occlusion of radial artery between the two groups (0.5 vs. 0.2%, p = 0.140). Unexpectedly, this study also showed no significant difference in bleeding risk between the groups.ConclusionDual-antiplatelet therapy for 1 month after TRCA was associated with a reduced risk of RAO and deemed safe.

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“…The thrombotic mechanism of RAO ensures that both anticoagulation dose and compression time remain important considerations of TRA (Goswami et al., 2016). A Heparin dose of 5000 units maybe protective of RAO while it has been well established that lower doses may be predictive of RAO (Bazemore and Mann, 2005).…”

Section: Discussionmentioning

confidence: 99%

Nursing-led ultrasound to aid in trans-radial access in cardiac catheterisation: a feasibility study

Williams

Condon

Davies

et al. 2020

Journal of Research in Nursing

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Background Trans-radial access is increasingly common for cardiac catheterisation. Benefits include reduced bleeding complications, length of hospital stay and costs. Aims To determine the feasibility of implementing a nurse-led ultrasound programme to measure radial artery diameter before and after cardiac catheterisation; to determine radial artery occlusion (RAO) rates, risk factors for RAO and predictors of radial artery (RA) diameter. Method A prospective observational cohort study design for 100 consecutive patients undergoing cardiac catheterisation, using RA access. Pre- and post-procedural RA diameter were measured using ultrasound, by specialist nurses trained to do so. Logistic regression analyses were performed to determine risk factors for RAO and predictors of RA diameter with results reported as odds ratios (OR) and 95% confidence intervals (CI). Results There were no adverse events, supporting the feasibility of nurse led ultrasound programmes. A 4% ( n = 4) rate of occlusion was observed. Haemostasis device application time of greater than 190 min was a predictor of RAO (OR 3.12, 95% CI 0.31–31). Male gender and height were predictors for a RA diameter of >2.2 mm. Conclusions Nurses can lead the assessment of RA occlusion using ultrasound to enhance planning and care, including monitoring compression times to reduce RAO.

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Radial Artery Occlusion After Cardiac Catheterization: Significance, Risk Factors, and Management

Cited by 16 publications

References 37 publications

Fourth generation e-cigarette vaping induces transient lung inflammation and gas exchange disturbances: results from two randomized clinical trials

Fourth generation e-cigarette vaping induces transient lung inflammation and gas exchange disturbances: results from two randomized clinical trials

Different Antiplatelet Strategies for Radial Artery Protection After Transradial Coronary Angiography—A Prospective Observational Cohort Study

Nursing-led ultrasound to aid in trans-radial access in cardiac catheterisation: a feasibility study

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