Seven french radial artery access for PCI: A prospective single-center experience

Tumscitz, Carlo; Pirani, Lucia; Tebaldi, Matteo; Campo, Gianluca; Biscaglia, Simone

doi:10.1016/j.ijcard.2014.07.134

Cited by 15 publications

(11 citation statements)

References 8 publications

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“…A previous study however, showed that 7-Fr sheath did not increase the incidence of RAO at 30 days follow-up after TRI compared with 6-Fr sheath (2% vs. 3.9%, p = 0.70). In addition, in a single center registry [11], 175 patients were subjected to TRI via radial artery through a 7-Fr Radifocus ® Introducer II (Terumo Corporation, Tokyo, Japan) with a 6-month follow-up, which observed an RAO rate of 6% (95% CI 3-11%) at manual assessment and 7% (95% CI 4-12%) at Doppler evaluation, consistent to those reported in previous studies (ranging from 5% to 38%) using a 6-Fr sheath.…”

Section: Discussionmentioning

confidence: 99%

“…In contrast, a previous study revealed that 7-Fr sheath did not increase the incidence of RAO at 30-day follow-up after TRI in comparison to 6-Fr sheath [9]. Furthermore, few studies have focused on the impact of 7-Fr sheath on long-term RAO after TRI with inconsistent conclusions [10][11][12]. Thus, the aim of this study was to explore the impact of 6-Fr and 7-Fr sheaths on the incidence of long-term RAO after TRI via vascular ultrasound.…”

Section: Introductionmentioning

confidence: 97%

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Comparison of long-term radial artery occlusion following trans-radial coronary intervention using 6-french versus 7-french sheaths

et al. 2021

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Background: The aim of this study was to explore the impact of 6-Fr and 7-Fr sheaths on the incidence of long-term radial artery occlusion (RAO) after trans-radial coronary intervention (TRI). , patients with ischemic heart disease including acute myocardial infarction and true bifurcation lesions were randomly assigned to 6-Fr group and 7-Fr group immediately after coronary angiography in a 1:1 ratio. The radial artery diameters were observed by ultrasound examination one day prior to TRI as well as at 30 days and 1 year after TRI. The primary endpoint was the incidence of RAO at 1-year after TRI. The secondary endpoints were the incidence of local vascular complications during hospitalization and changes of radial artery diameters within 1-year after TRI between the two groups. Additionally, multivariate logistic regression analysis was used to explore potential factors related to the incidence of long-term RAO after TRI. Results: A total of 214 patients were enrolled and randomly assigned to 6-Fr group (n = 105) or 7-Fr group (n = 109). There was no significant difference in the incidence of RAO at 1-year after TRI (8.57% vs. 12.84%, p = 0.313). Moreover, no significant difference was observed in the incidence of local vascular complications during hospitalization (20% vs. 24.77%, p = 0.403). After 1-year follow-up, no significant difference was found in radial artery diameters (2.63 ± 0.31 mm vs. 2.64 ± 0.27 mm, p = 0.802). Multivariate logistic analysis revealed that repeated TRI was an independent risk factor of long-term RAO 1 year after TRI (OR = 10.316,, p = 0.001). Conclusions: Compared to 6-Fr sheath, 7-Fr sheath did not increase short-term or long-term incidence of RAO after TRI. (Cardiol J XXXX; XX, X: xx-xx)

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 97%

Comparison of long-term radial artery occlusion following trans-radial coronary intervention using 6-french versus 7-french sheaths

et al. 2021

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“…Clinical methods (ie, arterial palpation) have been associated with both false‐negative and false‐positive findings attributed to low blood pressure, local edema and hematoma, subocclusive wall thrombus and trauma, remaining postprocedural tissue compression, as well as retrograde perfusion from the contralateral forearm artery. For example, although palpation appears to overestimate RAOs, one fifth to one third of patients with ultrasonographically documented RAOs may demonstrate palpable radial artery . Notably, the ulnar artery poses additional difficulties in determining patency status with palpation as a result of its deeper course compared with the radial artery .…”

Section: Discussionmentioning

confidence: 99%

Radial Artery and Ulnar Artery Occlusions Following Coronary Procedures and the Impact of Anticoagulation: ARTEMIS (Radial and Ulnar ARTE ry Occlusion M eta‐Analys IS ) Systematic Review and Meta‐Analysis

Hahalis

Aznaouridis

Tsigkas

et al. 2017

JAHA

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BackgroundIncidence of radial artery occclusions (RAO) and ulnar artery occclusions (UAO) in coronary procedures, factors predisposing to forearm arteries occlusion, and the benefit of anticoaggulation vary significantly in existing literature. We sought to determine the incidence of RAO/UAO and the impact of anticoagulation intensity.Methods and ResultsMeta‐analysis of 112 studies assessing RAO and/or UAO (N=46 631) were included. Overall, there was no difference between crude RAO and UAO rates (5.2%; 95% confidence interval [CI], 4.4–6.0 versus 4.0%; 95% CI, 2.8–5.8; P=0.171). The early occlusion rate (in‐hospital or within 7 days after procedure) was higher than the late occlusion rate. The detection rate of occlusion was higher with vascular ultrasonography compared with clinical evaluation only. Low‐dose heparin was associated with a significantly higher RAO rate compared with high‐dose heparin (7.2%; 95% CI, 5.5–9.4 versus 4.3%; 95% CI, 3.5–5.3; Q=8.81; P=0.003). Early occlusions in low‐dose heparin cohorts mounted at 8.0% (95% CI, 6.1–10.6). The RAO rate was higher after diagnostic angiographies compared with coronary interventions, presumably attributed to the higher intensity of anticoagulation in the latter group. Hemostatic techniques (patent versus nonpatent hemostasis), geography (US versus non‐US cohorts) and sheath size did not impact on vessel patency.ConclusionsRAO and UAO occur with similar frequency and in the order of 7% to 8% when evaluated early by vascular ultrasonography following coronary procedures. More‐intensive anticoagulation is protective. Late recanalization occurs in a substantial minority of patients.

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“…In addition a study conducted on 203 patients undergoing TRA who had normal, intermediate, and abnormal Allen test results found safety and feasibility of TRA across the whole spectrum of Allen test results thus pointing to the safety of TRA even in patients with abnormal Allen tests [24]. Also, new evidence suggests that PCI with 7 F guiding catheter is feasible and safe [25]. …”

Section: Discussionmentioning

confidence: 99%

Transradial versus transfemoral approach for coronary angiography and angioplasty – A prospective, randomized comparison

Bhat

Changal

Raina

et al. 2017

BMC Cardiovasc Disord

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BackgroundPCI has been done traditionally through transfemoral route. But now transradial and transbrachial routes are also coming up in practice. We compared transradial versus transfemoral routes for ease of operability, time for procedure, complications, and failure rates through a prospective study.MethodsFour hundred Patients admitted in department of cardiology for percutaneous interventions were enrolled in the study. 200 patients were assigned to each group randomly. A single team did all the procedures. Pre procedure, intra procedure and post procedure data of all the patients was collected, tabulated and analysed properly.ResultsAccess time (6.0 ± 1vs 4.2 ± 0.7; P =0.001); Fluoroscopy time and overall procedure time (29 ± 11.3 Vs. 27.3 ± 12.4 min) were more with trans radial than transfemoral route, respectively. The most common post procedure complication, ecchymosis was seen in 20.5% in transfemoral group compared to 12.5% in transradial group (P 0.031). Thrombophelibites (17.5 VS 8%, P0.004); Hematoma (14.5 Vs 0%, P 0.005); post procedure access bleed (7 VS 3%, P 0.039) were seen in transfemoral than transradial group, respectively. Failure rates were almost similar. None of our patients had post procedure myocardial infarction, stroke, acute renal failure and infections.ConclusionTransradial approach of PCI is better than transfemoral route with respect to complications like bleeding, haematoma formation, thrombophelebites and ecchymosis is concerned. However access and fluoroscopic time is more with the former. We recommend the transradial route for PCI.Trial registrationTrial is retrospectively registered in ClinicalTrials.gov with the Identifier: NCT02983721, Date of registration is December 2, 2016.

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Seven french radial artery access for PCI: A prospective single-center experience

Cited by 15 publications

References 8 publications

Comparison of long-term radial artery occlusion following trans-radial coronary intervention using 6-french versus 7-french sheaths

Comparison of long-term radial artery occlusion following trans-radial coronary intervention using 6-french versus 7-french sheaths

Radial Artery and Ulnar Artery Occlusions Following Coronary Procedures and the Impact of Anticoagulation: ARTEMIS (Radial and Ulnar ARTE ry Occlusion M eta‐Analys IS ) Systematic Review and Meta‐Analysis

Transradial versus transfemoral approach for coronary angiography and angioplasty – A prospective, randomized comparison

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