Radial Artery Patency after Trans-radial Cardiac Catheterization in a Bangladeshi Population

Abstract

Background: Transradial cardiac catheterization (TCC) is now preferred method over trans-femoral approach globally including Bangladesh. But the incidence of radial artery occlusion (RAO) after TCC is not infrequent and it ranges from 1-18% in different studies. The aim of our study was to see the incidence of RAO after TCC in a population coming for coronary angiogram and/or coronary intervention and also to evaluate the factors responsible for RAO. Methods: The observational prospective study was performed in all consecutive patients coming for TCC. Pre and three month post-procedural modified Allen’s test, reverse Barbeau test & Duplex ultrasonography for radial artery diameter (RAD), peak systolic velocity (PSV), end-diastolic velocity (EDV) and resistance index (RI) were measured. Results: 69 patients underwent TCC. Mean age was 54 years, 67% were male, 80% hypertensive, 65% diabetic. Follow-up at third month showed one total RAO (1.45%) and mean RAD of the remaining patients was significantly reduced from 2.2+0.03 mm to 2.1+0.03 mm (p=0.001) but none had any symptom or sign of ischemic hand. PSV, EDV & RI were not significantly altered. Reduction of RAD (to <2.0 mm) were significantly higher in female (p=0.032), but no association was found in presence of diabetes or its duration, hypertension, dyslipidaemia, smoking, peripheral vascular disease. The size & number of catheters used or duration of vascular access sheath kept in the artery did not affect the reduction of RAD.Conclusion: The mean RAD of the study was smaller than other study population, but incidence of RAO is very low. RAD was significantly reduced after procedure without any clinical evidence of ischemia or alteration of flow velocity. Female sex was the only factor found to be associated with reduction of RAD in this study.University Heart Journal Vol. 10, No. 2, July 2014; 66-72

Frequency of Radial Artery Occlusion in Patients Undergoing Percutaneous Cardiac Catheterization by Radial Access

“…Similarly, 63.8% with age >50 years were declared to be having RAO by Chowdhury. 12 Male into female percentage in our study was perceived to 63.4% versus 36.6% which is in line with the literature showed two thirds (66.7%) were male by Chowdhury. Another study reported comparable results with respect to gender (male 68.8% and female 32.2%).…”

“…Incidence of hypertension, diabetes mellitus (DM), dyslipidemia and smoking were 80%, 65%, 57% and 38% respectively. 12 A Study by Tuncez had inverse results with respect to high percentage of female gender (56.6%) and Hypertension (81.1%) DM (34.9%) Hyperlipidemia (85%) Smoking (47.2%). 1 Mean interval of Cine-fluoroscopy for coronary angiography was 2.75 ± 1.5 min and percutaneous coronary intervention (PCI) 8.29 ± 5.1 minutes.…”

“…15 The patency of these vessels can be checked by the Allen's test before starting the procedure but gold standard methods are color doppler USG and plethysmography. 12 Sinha et al 16 study 1945 consecutive patients undergone transradial catheterization demonstrated that RAO was found in 339 (174%) patients through color doppler USG on day 1, although pulse was still palpable on examination in 115 (34%) of these patients. While 30-day data showed RAO was found in 221 (11.4%) patients and 114 (52%) patients had palpable pulse.…”

Trans-radial Angioplasty of Anomalous Origin of Right Coronary Artery from Left Sinus of Valsalva - A Single-centre Experience

“…5 of 6 French guides were used in our cases owing to the transradial access route. Besides this, due to smaller body build and relatively smaller diameter of the radial artery (2.2±0.03 mm) 20 in our population, we could not use guides larger than 6 French, due to potential radial artery spasm. In their study, Nemani, et al 14 reported that the guide hooked the coronary selectively in 40% patients, while it had to be kept off ostium co-axial with the coronary in 55% patients, deep intubation with monitoring of the pressure in 5% of cases, all of which were strikingly similar to our approach.…”