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

Amoroso, Giovanni; Brug, Sander van der; Franx, Valerie; Dullemen, Anneleen van; Vecht-Kroeze, Gerda van der; Duinen, Mieke van

doi:10.1002/ccd.28758

Cited by 4 publications

(2 citation statements)

References 22 publications

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“…Reducing catheter size from 6F to 5 French (5F) slender and sheathless techniques might reduce incidence of complications, especially in women and older age groups. 18,[25][26][27] One study confirmed that in comparison with a 6F sheath, 20% more women and 10% more men complied with a sheath-to-artery ratio of less than 1 when using a 5F sheath. 27 Radial arteries with smaller diameter may cause more spasm due to catheter friction.…”

Section: Discussionmentioning

confidence: 96%

Treatment and Management of Upper Extremity Dysfunction Following Transradial Percutaneous Coronary Intervention: A Prospective Cohort Study

Cheung

Zwaan

Schreuders

et al. 2022

Hand (New York, N,Y.)

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Background: The transradial artery access is the benchmark approach in transradial percutaneous coronary intervention (TR-PCI). The purpose of this study was to evaluate the different complications, treatments, and outcome of upper extremity dysfunction following a TR-PCI. Methods: This was a prospective cohort substudy of patients with access-site complications. The study population consisted of 433 patients treated with TR-PCI. Referral to the hand center was mandated if the patient experienced new-onset or increase of preexistent symptoms in the upper extremity. Patients were followed up to the last control visit (5-7 months after the index procedure) at the hand center. Outcome results were categorized in “symptom-free,” “improvement of symptoms,” and “no improvement.” Results: Forty-one (9% of total) patients underwent assessment at the hand center. Most frequent referral indication was pain in the intervention arm. Women, preexisting sensibility disorder, and osteoarthritis in the intervention arm were associated with increased odds of referral. The most common complications diagnosed were carpal tunnel syndrome (n = 18) and osteoarthritis (n = 15). Thirty patients required further medical treatment. Immobilization therapy was most applied. Seventeen (4% of total) patients had persisting symptoms despite medical treatment. Conclusions: The occurrence of complications in the upper extremity after a TR-PCI is small. Despite medical treatment, symptoms persisted in 4% of all patients treated with TR-PCI. Possible explanations for the persisting symptoms are exacerbation of latent osteoarthritis and carpal tunnel syndrome by trauma-induced edema. Awareness of TR-PCI-induced complications among all specialists is essential to optimize patient care.

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Section: Discussionmentioning

confidence: 96%

Treatment and Management of Upper Extremity Dysfunction Following Transradial Percutaneous Coronary Intervention: A Prospective Cohort Study

Cheung

Zwaan

Schreuders

et al. 2022

Hand (New York, N,Y.)

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“…9 The QuickDASH has been used to assess the upper extremity function following TR-PCI. [10][11][12] The use of these patient-reported outcome measures (PROMs), however, has not yet been validated for TR-PCI induced complications in the upper extremity. The objective of this analysis was to establish the validity of the DASH and QuickDASH questionnaires for the assessment of upper extremity dysfunction (UED) following TR-PCI.…”

Section: Introductionmentioning

confidence: 99%

Predictive Value of the (Quick)DASH Tool for Upper Extremity Dysfunction Following Percutaneous Coronary Intervention

Zwaan¹,

Cheung²,

Ijsselmuiden³

et al. 2022

PROM

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The use of the Disability of the Arm, Shoulder and Hand (DASH) questionnaire and its shortened version, the QuickDASH, have been used to assess upper extremity function following a transradial percutaneous coronary intervention (TR-PCI). However, the use of these scores has not yet been validated for TR-PCI induced complications in the upper extremity. The aim of this study was to establish the validity of the DASH and the QuickDASH, for the assessment of upper extremity dysfunction following a transradial percutaneous coronary intervention (TR-PCI). Patients and Methods: This study was a diagnostic retrospective analysis of the ARCUS study, of whom 440 underwent TR-PCI and 62 control patients were treated via the transfemoral approach. All participants completed the DASH and QuickDASH questionnaire prior to the procedure and at each follow-up visit up to six months of follow-up. Receiver operating characteristics (ROC) were constructed to determine the validity of the questionnaires, using physical examinations to determine the occurrence of upper extremity dysfunction, according to the ARCUS study. Results: At each follow-up moment, the area under the curve (AUC) showed a poor ability of the DASH and QuickDASH to discriminate between patients with and without upper extremity dysfunction (AUC: 0.565-0.586). There was no significant difference between the questionnaires (p > 0.05). Conclusion:The DASH and QuickDASH questionnaires are both equally incapable of discriminating between patients with and without upper extremity dysfunction following a TR-PCI. Study results suggest that the DASH and QuickDASH questionnaires are incapable of discerning changes in upper extremity function as a result of procedural complications following a TR-PCI vs cardiac induced activity cessation.

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Limb dysfunction after transradial access: A search for an understanding

Gilchrist

2020

Cathet Cardio Intervent

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

Cited by 4 publications

References 22 publications

Treatment and Management of Upper Extremity Dysfunction Following Transradial Percutaneous Coronary Intervention: A Prospective Cohort Study

Treatment and Management of Upper Extremity Dysfunction Following Transradial Percutaneous Coronary Intervention: A Prospective Cohort Study

Predictive Value of the (Quick)DASH Tool for Upper Extremity Dysfunction Following Percutaneous Coronary Intervention

Limb dysfunction after transradial access: A search for an understanding

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