Rationale and design of the ARCUS: Effects of trAnsRadial perCUtaneouS coronary intervention on upper extremity function

Zwaan, Eva; Ijsselmuiden, Alexander; Rosmalen, Joost van; Geuns, Robert‐Jan M. van; Amoroso, Giovanni; Moerman, Esther; Ritt, Marco J.P.F.; Schreuders, Ton A.R.; Kofflard, Marcel; Holtzer, C.A.J.

doi:10.1002/ccd.26525

Cited by 23 publications

(36 citation statements)

References 36 publications

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“…The aims and design of the "Effects of trAnsRadial perCUtaneouS (ARCUS) coronary intervention on upper extremity function" study have been published previously [4] . A target enrolment of 500 patients has been planned.…”

Section: Methodsmentioning

confidence: 99%

“…Subsequently, diagnosis and diagnostic procedures performed at the hand centre will be registered. Also, the administered therapy and upper extremity related absence of work in days will be registered [4] . These results will be published and analysed in the final paper.…”

Section: Study Endpointsmentioning

confidence: 99%

“…The details of the statistical analyses have been published previously [4] . The results are presented as means ± SD and counts and percentages.…”

Section: Statistical Analysesmentioning

confidence: 99%

“…For normally distributed variables the independent sample t-test was used, and the Mann-Whitney U test for continuous variables that are not normally distributed. Additionally, differences in the two upper extremity scores (intervention side -non-intervention side) collected in each patient will be analysed using Mc Nemar's test [4] . All tests were two-sided, with a statistical significance level set at 5% .…”

Section: Statistical Analysesmentioning

confidence: 99%

“…The transradial access is being increasingly adopted as the preferred approach for angioplasties, as it is associated with significantly lower rates of procedural complications, shorter hospitalisations, greater patient satisfaction and lower costs than the transfemoral access, which, on the other hand, is technically less challenging and associated with a steeper learning curve [1][2][3][4][5] . However, the precise effects of transradial procedures on the upper extremities function are unknown.…”

Section: Introductionmentioning

confidence: 99%

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Upper Extremity Function after Transradial Percutaneous Coronary Intervention Short-Term Interim Results of the ARCUS Study

Ijsselmuiden¹,

Holtzer²,

Zwaan³

et al. 2017

JHC

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Aims: To examine the short-term effects of transradial percutaneous coronary interventions on the upper extremities function. Method and results:This is an interim analysis of the Effects of trAnsRadial perCUtaneouS coronary intervention on upper extremity function (ARCUS) study. Out of 191 patients evaluated at 2 weeks after they had undergone a transradial percutaneous coronary intervention, 120 (62.8 % ) had manifestations of upper extremity dysfunction on the side of the intervention. The main abnormalities were a decrease in sensibility, a ≥ 15 % increase in the Disabilities of the Hand and Shoulder questionnaire score and a ≥ 2 cm increase in hand and forearm volumes. Radial artery occlusions occurred in 12 patients in the upper extremity dysfunction versus 1 patient in the no upper extremity dysfunction group (p = 0.03). Patients with upper extremity dysfunction were significantly more likely to have a family history of heart disease (50 % vs. 26.8 % ; p = 0.002). In addition, there was a trend (p = 0.07) toward a greater proportion of previous smokers in the group with upper extremity dysfunction than in the other group. Conclusions: Upper extremity dysfunction after transradial percutaneous coronary intervention is a medical concern. However, our original score may be overly sensitive and overestimate the rate of upper extremity dysfunction. Further analyses are needed, as well as perhaps a modification of the primary endpoint.

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Section: Methodsmentioning

confidence: 99%

Section: Study Endpointsmentioning

confidence: 99%

“…The details of the statistical analyses have been published previously [4] . The results are presented as means ± SD and counts and percentages.…”

Section: Statistical Analysesmentioning

confidence: 99%

Section: Statistical Analysesmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Upper Extremity Function after Transradial Percutaneous Coronary Intervention Short-Term Interim Results of the ARCUS Study

Ijsselmuiden¹,

Holtzer²,

Zwaan³

et al. 2017

JHC

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SCAI expert consensus statement update on best practices for transradial angiography and intervention

Shroff

Gulati

Drachman

et al. 2019

Cathet Cardio Intervent

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Transradial angiography and intervention continues to become increasingly common as an access site for coronary procedures. Since the first "Best Practices" paper in 2013, ongoing trials have shed further light onto the safest and most efficient methods to perform these procedures. Specifically, this document comments on the use of ultrasound to facilitate radial access, the role of ulnar artery access, the utility of non-invasive testing of collateral flow, strategies to prevent radial artery occlusion, radial access for primary PCI and topics that require further study.

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Slender versus conventional approach reduces post‐procedural upper extremity dysfunction after transradial coronary procedures

Amoroso

Brug

Franx

et al. 2020

Cathet Cardio Intervent

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AimsWe compared the incidence of post‐procedural radial artery occlusion (RAO) and upper extremity dysfunction (UED), in patients undergoing conventional versus slender transradial (TRA) coronary procedures.Methods and resultsUED was assessed by the QuickDASH, before conventional (i.e., ≥6F) and slender (i.e., “virtual” 3F to 5F) procedures, after 2 weeks and 2 months. RAO was assessed by Duplex in patients with an abnormal reversed Barbeau test (RBT). A total of 212 patients were included, UED after 2 weeks was 12%, and after 2 months 7% (p = <.001). RAO occurred in 3%. Multivariate analysis showed an OR of 0.26 (CI0.08–0.84) for UED at 2 weeks (p = .03) in favor of slender TRA. In patients with RAO, UED did not improve at 2 months (2/5, 40%, p = .046).ConclusionsThe occurrence of UED after TRA procedures is temporary except for patients with RAO. Slender TRA seems able to reduce short term UED.

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Rationale and design of the ARCUS: Effects of trAnsRadial perCUtaneouS coronary intervention on upper extremity function

Abstract: Results from this study will elucidate the effect of TR-PCI on upper extremity function. This creates the opportunity to further optimize TR-PCI, to make improvements in functional outcome and to prevent morbidity regarding full upper extremity function. © 2016 Wiley Periodicals, Inc.

Cited by 23 publications

References 36 publications

Upper Extremity Function after Transradial Percutaneous Coronary Intervention Short-Term Interim Results of the ARCUS Study

Upper Extremity Function after Transradial Percutaneous Coronary Intervention Short-Term Interim Results of the ARCUS Study

SCAI expert consensus statement update on best practices for transradial angiography and intervention

Slender versus conventional approach reduces post‐procedural upper extremity dysfunction after transradial coronary procedures

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