Total Radial Artery Occlusion Following Transradial Access: Complete
                        Recanalization via the Anatomical Snuffbox

Purpose: Radial artery occlusion (RAO) is one of the common complications after coronary intervention via the conventional radial artery approach. The purpose of the study was to explore the safety and feasibility of retrograde recanalization of the occluded radial artery via a distal radial artery (DRA) approach. Methods: Combined with the practice of our centre and a literature review, we summarized the procedure of retrograde recanalization of RAO, success rate, and complications. Results: A total of 14 of 15 patients with 15 pieces of occluded radial arteries were successfully recanalized via the DRA in our centre. In the 15 occluded vessels, 11 vessels (73.3%) had total occlusion and 4 vessels (26.7%) had functional occlusion. Four of 15 occluded vessels were acute occlusions. Two acute RAOs were only treated with aspiration via sheath, 11 RAOs with balloon angioplasty, and 2 RAOs with both, respectively. In 6 patients, cardiac catheterization was carried out via the DRA after recanalizing the RAO. A total of 10 studies reporting the results of recanalization of RAO via the DRA were systematically retrieved in the present study. In 3 case series, the number of cases was more than 5, and the success rate of recanalization was more than 85.7%. Two studies reported complications, including dissection in one case, hematoma in 2 cases, and pain in the forearm during angioplasty. Conclusions: Recanalization of the occluded radial artery via the DRA was safe and effective. When repeat cardiac catheterization was required, recanalization of the RAO and subsequent coronary angiography or intervention through the ipsilateral radial artery approach was feasible.

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“…Except for Ali et al’s study, all of the studies described repeated cardiac catheterization via the recanalized radial artery. 17…”

Section: Resultsmentioning

confidence: 99%

“…In recent years, an increasing number of studies have focused on retrograde recanalization of occluded proximal radial artery via DRA access. [10][11][12][13][14][15][16][17][18][19] However, most of them were case reports or case series, and there is a lack of large sample studies to confirm its safety and effectiveness.…”

Section: Introductionmentioning

confidence: 99%

Retrograde Recanalization of Occluded Radial Artery: A Single-Centre Experience and Literature Review

et al. 2022

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“…It was first introduced by Kiemeneij in 2017 and since then, the feasibility and safety of CC through dTRA have been proved by many studies [ 6 , 7 , 10 ]. Compared with TRA, this technique has advantages in faster hemostasis, lower risk of radial artery occlusion (RAO) and recanalizing RA stenosis or RAO [ 7 , 11 ]. However, none of these previous studies reported the safety and feasibility of CAG and PCI via dTRA in case of RA anatomical variation, such as SRA.…”

Section: Discussionmentioning

confidence: 99%

Coronary catheterization via distal transradial access in patient with superficial radial artery: a case report

Wang

Zhang

et al. 2021

BMC Cardiovasc Disord

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Background The routine radial artery (RA) puncture may fail when anatomical variation of the RA is encountered. Superficial radial artery (SRA) is one of the anatomic variants of the RA, with the incidence of about 1 to 1.5%. Recently, distal transradial access (dTRA) has emerged as a novel approach for coronary catheterization (CC), but performing CC through dTRA in patient with SRA has never been reported. Case presentation A 57-year-old male was admitted to hospital due to intermittent chest pain for 4 days. He was diagnosed with unstable angina pectoris and planned to receive coronary angiography (CAG). Before the operation, the existence and course of SRA were confirmed by palpation and ultrasonography with color Doppler. We marked the puncture site under the guidance of ultrasonography and successfully performed CC through the dTRA during patient’s hospitalization. Conclusions As far as we know, this is the first report that presents a case of SRA and percutaneous coronary intervention (PCI) treatment in which was successfully performed through dTRA. It is safe and feasible to perform CC via dTRA in case of SRA, and dTRA seems to be the preferred access.

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“…However, this extra procedure carries with it additional risks of other access site complications such as dissection and hematoma. [30][31][32] Lastly, radial artery occlusion can be symptomatic, resulting in paresthesia (1.52-1.61%), pain at the site of puncture or occlusion (6.67-7.77%), or reduced hand/digit motor function (0.26-0.49%). 33 34 Some of these complaints may be self-limiting, but there is currently inadequate follow-up data to estimate the duration of symptoms accurately (table 1).…”

Section: Radial Artery Occlusionmentioning

confidence: 99%

Radial artery access for neuroendovascular procedures: safety review and complications

Narsinh¹,

Mirza

Caton

et al. 2021

J NeuroIntervent Surg

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Although enthusiasm for transradial access for neurointerventional procedures has grown, a unique set of considerations bear emphasis to preserve safety and minimize complications. In the first part of this review series, we reviewed anatomical considerations for safe and easy neuroendovascular procedures from a transradial approach. In this second part of the review series, we aim to (1) summarize evidence for safety of the transradial approach, and (2) explain complications and their management.

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Total Radial Artery Occlusion Following Transradial Access: Complete Recanalization via the Anatomical Snuffbox

Cited by 12 publications

References 14 publications

Retrograde Recanalization of Occluded Radial Artery: A Single-Centre Experience and Literature Review

Retrograde Recanalization of Occluded Radial Artery: A Single-Centre Experience and Literature Review

Coronary catheterization via distal transradial access in patient with superficial radial artery: a case report

Radial artery access for neuroendovascular procedures: safety review and complications

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