Radial artery occlusion after transradial coronary catheterization

Avdikos, Grigorios; Karatasakis, Aris; Tsoumeleas, Andreas; Lazaris, Efstathios; Ziakas, Antonios; Koutouzis, Michael

doi:10.21037/cdt.2017.03.14

Cited by 99 publications

(70 citation statements)

References 82 publications

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“…RAO after transradial access is most commonly asymptomatic and occurs in 1–10% of cases 27–29. The occurrence of RAO in the cardiac literature based on sheath sizes used was summarized in a recent article30 showing RAO rates of 0% for 3F sheathless guiding catheters and 4F sheaths, up to 13.7% RAO rates for 5F sheaths, 30.5% for 6F sheaths, and 19% for 7F sheaths. Some of the information may be limited given the different time points at which RAO was evaluated and the possibility of spontaneous resolution of the thrombosis over time.…”

Section: Discussionmentioning

confidence: 99%

Distal radial access in the anatomical snuffbox for neurointerventions: a feasibility, safety, and proof-of-concept study

Kühn

Rodrigues

Singh

et al. 2020

J NeuroIntervent Surg

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PurposeTo report the first use of distal radial artery (dRA) access for a variety of neurointerventions and to demonstrate the safety and feasibility of this approach.MethodsA retrospective review of our prospective neurointerventional database of endovascular interventions was conducted and, between May and October 2019, all patients in whom the intervention was performed via dRA in the anatomical snuffbox were identified. Patient demographics, clinical information, procedural and radiographic data were collected.Results48 patients with a mean age of 64.4 years (range 35–84 years) were included. 27 patients were female. dRA access was achieved in all cases. Conversion to femoral access was required in five cases (10.4%) due to tortuous vessel anatomy and limited support of the catheters in the aortic arch. Interventions performed included aneurysm treatment (with flow diverters, Woven EndoBridge device placement, coiling or stent-assisted coiling), arteriovenous malformation and dural arteriovenous fistula embolization, carotid artery stentings, stroke thrombectomy, thrombolysis for central retinal artery occlusion, intracranial stenting, middle meningeal artery embolization, vasospasm treatment, and spinal angiography with embolization. Radial artery vasospasm was seen in two cases and successfully treated with antispasmolytic medication. No symptomatic radial artery occlusion or ischemic event was observed.ConclusiondRA access is safe and effective for a variety of neurointerventions. Our preliminary experience with this approach is very promising and shows high patient satisfaction.

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Section: Discussionmentioning

confidence: 99%

Distal radial access in the anatomical snuffbox for neurointerventions: a feasibility, safety, and proof-of-concept study

Kühn

Rodrigues

Singh

et al. 2020

J NeuroIntervent Surg

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“…We did not have follow-up to assess for radial artery occlusion (RAO) and this was a limitation to our study. Ideally, the reverse Barbeau’s test and Doppler ultrasonography would be used to assess for RAO 17. Future studies on continuation of DOAC during coronary angiography should consider evaluating radial artery patency postprocedure.…”

Section: Discussionmentioning

confidence: 99%

Performing diagnostic radial access coronary angiography on uninterrupted direct oral anticoagulant therapy: a prospective analysis

et al. 2019

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PurposeWe sought to assess the safety of performing diagnostic radial access coronary angiography with uninterrupted anticoagulation on patients receiving direct oral anticoagulant therapy.BackgroundDirect oral anticoagulants have become a popular choice for the prevention of thromboembolism. Risk factors for thromboembolism are common among cardiovascular conditions and indications for direct oral anticoagulant therapy as well as coronary angiography often overlap in patients. It has been hypothesised that uninterrupted direct oral anticoagulant therapy would increase haemorrhagic and access site complications, however data in this area is limited.MethodsThis was a prospective observational analysis of 49 patients undergoing elective diagnostic coronary angiography while receiving uninterrupted anticoagulation with direct oral anticoagulants. This population was compared with a control group of 49 unselected patients presenting to the cardiology service for elective diagnostic coronary angiography. Continuous variables were analysed using the independent samples t-test and categorical variables using Pearson’s χ2 test.ResultsThe mean duration of radial compression for the control group was 235.8±62.8 min and for the uninterrupted direct oral anticoagulant group was 258.4±56.5 min. There was no significant difference in mean duration of radial compression (p=0.07; 95% CI=-1.4 to 46.5). There was also no difference in the complication rate between the two groups (p=1).ConclusionsWe observed similar complication rates and radial artery compression time postangiography in both groups. This small prospective observational study suggests that uninterrupted continuation of direct oral anticoagulants during coronary angiography is safe. Larger randomised control studies in this area would be beneficial.

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“…Посткатетеризационная окклюзия лучевой артерии (ОЛА) (рис. 1) может наблюдаться, по разным данным, до 10 % [8].…”

Section: Introductionunclassified

Radial artery occlusion after primary percutaneous coronary interventions performed using different radial approaches

Akhramovich¹,

Семитко²,

Азаров³

et al. 2020

PKiK

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Aim. The analyses of radial artery patency during hospitalisation in patients with acute coronary syndrome after percutaneous coronary interventions were performed using three options of radial approaches, i.e. traditional, classical and dorsopalmar distal radial approaches.Methods. Patients (n = 178) with acute coronary syndrome on whom endovascular procedure by the traditional and two options of distal radial approach were performed met the entry criteria. The classical distal radial approach was performed within an anatomic snuffbox in 65 patients (36.5%), and the dorsopalmar type was performed in 29 patients (16.3%); the traditional radial approach was performed in 84 patients (47.2%). On completion of the percutaneous coronary interventions and final radial artery angiography, hemostasis was performed with bandage application for 6 h. From the 5th to the 7th day after intervention, examination, palpation and ultrasound duplex scan were performed in every patient.Results. Examination, palpation and ultrasound duplex scan performed from the 5th to 7th day after intervention revealed 3 cases (1.7%) of forearm radial artery occlusion (high type). All the 3 cases were in the traditional radial approach group. Access side radial artery occlusion (at the anatomical snuffbox and the dorsum of the plant [local type]) with saved blood supplement on the forearm was registered in the classical distal radial approach group in 4 cases (2.3%). There were no cases of access side radial artery occlusion in the dorsopalmar group.Conclusion. The use of the distal radial approach for primary percutaneous coronary intervention in patients with acute coronary syndrome definitely reduces the risk of radial artery occlusion of the forearm, whereas the dorsopalmar distal radial approach can be considered as a basic approach.Received 11 May 2020. Revised 31 May 2020. Accepted 3 June 2020.Funding: The study did not have sponsorship.Conflict of interest: Authors declare no conflict of interest.Author contributions Conception and design: S.P. Semitko, R.V. Akhramovich Data collection and analysis: R.V. Akhramovich, I.S. Melnichenko Drafting the article: R.V. Akhramovich Critical revision of the article: S.P. Semitko Final approval of the version to be published: R.V. Akhramovich, S.P. Semitko, A.V. Azarov, I.S. Melnichenko, A.I. Analeev, I.E. Chernyisheva, A.A. Tretyakov, D.G. Ioseliani

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Radial artery occlusion after transradial coronary catheterization

Cited by 99 publications

References 82 publications

Distal radial access in the anatomical snuffbox for neurointerventions: a feasibility, safety, and proof-of-concept study

Distal radial access in the anatomical snuffbox for neurointerventions: a feasibility, safety, and proof-of-concept study

Performing diagnostic radial access coronary angiography on uninterrupted direct oral anticoagulant therapy: a prospective analysis

Radial artery occlusion after primary percutaneous coronary interventions performed using different radial approaches

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