17
views
0
recommends
+1 Recommend
0 collections
    4
    shares
      • Record: found
      • Abstract: found
      • Article: found
      Is Open Access

      Incidence and Predictors of Radial Artery Occlusion Associated Transradial Catheterization

      research-article

      Read this article at

      Bookmark
          There is no author summary for this article yet. Authors can add summaries to their articles on ScienceOpen to make them more accessible to a non-specialist audience.

          Abstract

          In this study , we sought to assess the incidence and predictors of radial artery occlusion (RAO), which is a significant complication of transradial cardiac catheterization. We prospectively evaluated the results of 106 patients who underwent coronary angiography and percutaneous coronary intervention (PCI) via the transradial approach (TRA). At the 3 rd h of intervention, the radial artery was checked by palpation; color doppler ultrasonography was performed at the 24 th h. Fluoroscopy duration, procedure success, and complications of the radial artery were recorded. The procedure was successfully completed in all patients. RAO was detected in eight female and two male patients. In terms of RAO, there was a statistically significant difference between males and females (p=0.019). Other parameters did not show a significant correlation with RAO. Altough did not have any effect on procedural success, eight patients developed transient radial artery spasm. Gender was not associated with radial arterial spasms (p=0.19). TRA in the diagnosis and treatment of coronary artery disease has shown high procedural success and low complication rates; it addition, it presents a low economic burden. It should be used widely and be involved in the routine cardiology residency program.

          Related collections

          Most cited references30

          • Record: found
          • Abstract: found
          • Article: not found

          Radial versus femoral approach for percutaneous coronary diagnostic and interventional procedures; Systematic overview and meta-analysis of randomized trials.

          We sought to compare, through a meta-analytic process, the transradial and transfemoral approaches for coronary procedures in terms of clinical and procedural outcomes. The radial approach has been increasingly used as an alternative to femoral access. Several trials have compared these two approaches, with inconclusive results. The MEDLINE, CENTRAL, and conference proceedings from major cardiologic associations were searched. Random-effect odds ratios (ORs) for failure of the procedure (crossover to different entry site or impossibility to perform the planned procedure), entry site complications (major hematoma, vascular surgery, or arteriovenous fistula), and major adverse cardiovascular events (MACE), defined as death, myocardial infarction, emergency revascularization, or stroke, were computed. Twelve randomized trials (n = 3,224) were included in the analysis. The risk of MACE was similar for the radial versus femoral approach (OR 0.92, 95% confidence interval [CI] 0.57 to 1.48; p = 0.7). Instead, radial access was associated with a significantly lower rate of entry site complications (OR 0.20, 95% CI 0.09 to 0.42; p < 0.0001), even if at the price of a higher rate of procedural failure (OR 3.30, 95% CI 1.63 to 6.71; p < 0.001). The radial approach for coronary procedures appears as a safe alternative to femoral access. Moreover, radial access virtually eliminates local vascular complications, thanks to a time-sparing hemostasis technique. However, gaining radial access requires higher technical skills, thus yielding an overall lower success rate. Nonetheless, a clear ongoing trend toward equalization of the two procedures, in terms of procedural success, is evident through the years, probably due to technologic progress of materials and increased operator experience.
            Bookmark
            • Record: found
            • Abstract: found
            • Article: not found

            Prevention of radial artery occlusion-patent hemostasis evaluation trial (PROPHET study): a randomized comparison of traditional versus patency documented hemostasis after transradial catheterization.

            The objective of this study was to evaluate the efficacy of hemostasis with patency in avoiding radial artery occlusion after transradial catheterization. Radial artery occlusion is an infrequent but discouraging complication of transradial access. It is related to factors such as sheath to artery ratio and is less common in patients receiving heparin. Despite being clinically silent in most cases, it limits future transradial access. Four hundred thirty-six consecutive patients undergoing transradial catheterization were prospectively enrolled in the study. Two hundred nineteen patients were randomized to group I, and underwent conventional pressure application for hemostasis. Two hundred seventeen patients were randomized to group II and underwent pressure application confirming radial artery patency using Barbeau's test. Radial artery patency was studied at 24 hr and 30 days using Barbeau's test. Thirty-eight patients had evidence of radial artery occlusion at 24 hr. Twenty patients had persistent evidence of radial artery occlusion at 1 month. Group II, with documented patency during hemostatic compression, had a statistically and clinically lower incidence of radial artery occlusion (59% decrease at 24 hr and 75% decrease at 30 days, P < 0.05), compared with patients in group I. Low body weight patients were at significantly higher risk of radial artery occlusion. No procedural variables were found to be associated with radial artery occlusion. Patent hemostasis is highly effective in reducing radial artery occlusion after radial access and guided compression should be performed to maintain radial artery patency at the time of hemostasis, to prevent future radial artery occlusion. Copyright 2008 Wiley-Liss, Inc.
              Bookmark
              • Record: found
              • Abstract: found
              • Article: not found

              Percutaneous radial artery approach for coronary angiography.

              Percutaneous entry into the distal radial artery and selective coronarography using a French 5 sheath and preshaded catheters were attempted in 100 patients with a normal Allen test. Cannulation of the radial artery was not possible in ten patients, and selective catheterization of the coronary arteries was unsuccessful in two. Manipulation of catheters presented no problem, and arterial spasm was rarely observed, only before the use of a 23-cm-long sheath. Only two complications without symptoms were observed: arterial dissection of the brachial artery in one patient and occlusion of the radial artery in another. With experience, this approach may become as effective and possibly safer than the transbrachial entry.
                Bookmark

                Author and article information

                Journal
                Int J Med Sci
                Int J Med Sci
                ijms
                International Journal of Medical Sciences
                Ivyspring International Publisher (Sydney )
                1449-1907
                2013
                3 October 2013
                : 10
                : 12
                : 1715-1719
                Affiliations
                1. Division of Cardiology, Konya Numune State Hospital, Konya,
                2. Department of Cardiology, Mevlana University, Konya
                3. Department of Cardiology, Turkish High Specialty Hospital, Ankara
                4. Department of Cardiology, Dicle University, Diyarbakır1
                5. Divison of Cardiology, Malkara State Hospital, Tekirdağ
                6. Division of Cardiology, Beyhekim State Hospital, Konya
                7. Department of Cardiology, Mustafa Kemal University, Hatay
                Author notes
                ✉ Corresponding author: Dr. Zeynettin Kaya, Department of Cardiology, Mevlana University, Yeni Istanbul Cad. No: 235. 42003 Selçuklu / KONYA, Turkey. 05052537049. E-mail: zeynettinkaya@ 123456yahoo.com

                COMPETING INTERESTS: The authors have declared that no competing interest exists.

                Article
                ijmsv10p1715
                10.7150/ijms.7087
                3804796
                24151442
                98323e0b-2f97-4814-baf7-32583d48b3dc
                © Ivyspring International Publisher. This is an open-access article distributed under the terms of the Creative Commons License (http://creativecommons.org/licenses/by-nc-nd/3.0/). Reproduction is permitted for personal, noncommercial use, provided that the article is in whole, unmodified, and properly cited.
                History
                : 4 July 2013
                : 21 August 2013
                Categories
                Research Paper

                Medicine
                radial artery occlusion,transradial approach,radial arterial spasm
                Medicine
                radial artery occlusion, transradial approach, radial arterial spasm

                Comments

                Comment on this article