Unusual Vascular Complications Associated with Transradial Coronary Procedures Among 10,324 Patients: Case Based Experience and Treatment Options

Tatlı, Ersan; Buturak, Ali; Cakar, Akif; Vatan, Bülent; Değirmencioğlu, Aleks; Agac, TARıK M.; Kılıç, Harun; Gündüz, Hüseyin; Akdemir, Ramazan

doi:10.1111/joic.12206

Cited by 58 publications

(66 citation statements)

References 26 publications

(29 reference statements)

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“…In addition, transradial access is associated with earlier ambulation, greater patient comfort, and earlier discharges from the hospital [2,3]. The low incidence of AV fistula formation complicating transradial coronary angiography is illustrated in a recent large case series of 10,324 patients by Tatli et al, where only four cases of AV fistula were documented [1]. Patients with iatrogenic radial AV fistula are usually asymptomatic and typically present with a pulsatile mass, thrill, or bruit over the wrist [6,7].…”

Section: Discussionmentioning

confidence: 99%

“…The natural history of radial AV fistula is thought to be benign with most cases resolving spontaneously [1,2], although serious consequences in the form of high output cardiac failure and distal limb ischemia can potentially occur. As in transfemoral AV fistula, three management strategies have been explored in transradial AV fistula, namely conservative management (including mechanical compression), implantation of covered stents and surgical repair [2].…”

Section: Discussionmentioning

confidence: 99%

“…Earlier case reports on radial AV fistula have all utilized the use of surgical ligation, with a range of presentation from 2 months post-angiography up to 1 year [1,2,4,6,8,9] (Table 1). Out of the four AV fistula cases from Tatli et al, only one case required surgical ligation [1].…”

Section: Discussionmentioning

confidence: 99%

“…Transradial access for coronary angiography and intervention has become increasingly popular and is even recommended as the default coronary intervention strategy by the European Association of Percutaneous Cardiovascular Interventions (EAP-CI) [1]. Access site vascular complications, including hematomas, retroperitoneal hematomas, arteriovenous (AV) fistula, pseudoaneurysms, and arterial dissection/occlusion have all been shown to be significantly reduced via the transradial approach compared to the transfemoral approach [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

“…Access site vascular complications, including hematomas, retroperitoneal hematomas, arteriovenous (AV) fistula, pseudoaneurysms, and arterial dissection/occlusion have all been shown to be significantly reduced via the transradial approach compared to the transfemoral approach [1][2][3][4].…”

Section: Introductionmentioning

confidence: 99%

See 4 more Smart Citations

Arteriovenous Fistula as a Rare Early Complication of Transradial Coronary Angiography: With Literature Review on Management Strategies

Chieng

Patel

2015

J Med Cases

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Iatrogenic arteriovenous (AV) fistula is a vascular complication which may result from coronary angiography. Whilst infrequent via transfemoral access, the incidence in transradial angiography is even rarer with mostly case reports in the literature. Most of these had thus far described transradial AV fistula formation as a delayed complication requiring surgical intervention. Here we describe a rare early case of transradial AV fistula complicating coronary intervention which was managed conservatively with mechanical compression. Follow-up imaging confirmed resolution of fistula. We also reviewed the existing literature on management strategies for transradial AV fistula. We support the use of conservative management as the firstline treatment option for transradial AV fistula, with surgical options reserved for cases involving limb vascular compromise and cardiac insufficiency.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 3 more Smart Citations

Arteriovenous Fistula as a Rare Early Complication of Transradial Coronary Angiography: With Literature Review on Management Strategies

Chieng

Patel

2015

J Med Cases

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Profile and outcomes of patients with mediastinal hematoma after cardiac catheterization: A retrospective analysis

Luo

Yang

Zhang

et al. 2022

Cathet Cardio Intervent

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Distal versus conventional radial artery access for coronary catheterization: A systematic review and meta‐analysis

Feghaly

Chen

Blanco

et al. 2023

Cathet Cardio Intervent

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Background The distal radial artery (DRA) access is an alternative to the conventional radial artery (CRA) access for coronary angiography and interventions and appears to be associated with reduced incidence of certain outcomes. Methods A systematic review was performed to evaluate differences between DRA versus CRA access for coronary angiography and/or interventions. Following preferred reporting items for systematic review and meta‐analysis‐protocols guidelines, two reviewers independently selected studies published in the electronic databases (MEDLINE, EMBASE, SCOPUS, CENTRAL) from inception to October 10, 2022, followed by data extraction, meta‐analysis, and quality assessment. Results The final review included 28 studies with (total: 9151 patients [DRA: 4474; CRA: 4677]). Compared with CRA, DRA access was found to be associated with a shorter time to achieve hemostasis (mean difference, MD: −32.49 [95% confidence interval, CI: −65.53, −2.46], p < 0.00001), and reduced incidence of radial artery occlusion (RAO) (risk ratio, RR: 0.38 [95% CI: 0.25, 0.57], p < 0.00001), any bleeding (RR: 0.44 [95% CI: 0.22, 0.86], p = 0.02), and pseudoaneurysm (RR: 0.41 [95% CI: 0.18, 0.99], p = 0.05). However, DRA access has increased access time (MD: 0.31 [95% CI: −0.09, 0.71], p < 0.00001) and crossover rates (RR: 2.75 [95% CI: 1.70, 4.44], p < 0.00001). There were no statistically significant differences in other technical aspects and complications. Conclusion DRA access is a safe and feasible approach for coronary angiography and interventions. Compared to CRA, DRA provides a shorter hemostasis time, lower incidence of RAO, any bleeding, and pseudoaneurysm, and is associated with increased access time and crossover rates.

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Unusual Vascular Complications Associated with Transradial Coronary Procedures Among 10,324 Patients: Case Based Experience and Treatment Options

Abstract: Hemorrhagic and vascular complications are rarely seen during TRC. However, majority of these complications could be managed conservatively without a requirement for surgical reconstruction.

Cited by 58 publications

References 26 publications

Arteriovenous Fistula as a Rare Early Complication of Transradial Coronary Angiography: With Literature Review on Management Strategies

Arteriovenous Fistula as a Rare Early Complication of Transradial Coronary Angiography: With Literature Review on Management Strategies

Profile and outcomes of patients with mediastinal hematoma after cardiac catheterization: A retrospective analysis

Distal versus conventional radial artery access for coronary catheterization: A systematic review and meta‐analysis

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