Comparison of Standard Catheters Versus Radial Artery–Specific Catheter in Patients Who Underwent Coronary Angiography Through Transradial Access

Background: There is limited data on feasibility and safety of coronary interventions performed using radial artery at anatomical snuffbox as vascular access point in South Asian region. Our study attempts to evaluate the feasibility and safety of coronary angiography and percutaneous coronary intervention using transradial access at anatomical snuffbox.Methods: Transradial access at anatomical snuffbox was attempted in 128 consecutive patients, who were planned for coronary angiography and/or percutaneous coronary intervention. Success in vascular access, completion of planned procedure and complications encountered, including patency of radial artery after the procedure, were investigated. Results: A total of 128 patients (76 males [59.4%]; 52 females [40.6%]) between 44-78 years of age (mean age, 59.0 +/- 10.2 years) were included in the study. Distal radial artery puncture and sheath placement was successful in all patients however planned procedure was completed in 126 (98.4%) patients. Total 90 coronary angiographies and 36 percutaneous coronary interventions were performed of which five were primary percutaneous coronary intervention. We encountered brachial artery spasm among two patient (1.5%) and significant pain and swelling among three patients (2.3%). No bleeding complication, numbness or parasthesia were observed on follow-up. Patients had average pain rating of 2.4+/- 1.1 in visual analogue pain rating scale. There were no instances of radial artery occlusion after the procedure.Conclusions: Distal radial artery, at anatomical snuffbox, is a safe and feasible alternative vascular access site for coronary angiography and percutaneous coronary intervention. Keywords: Cardiac catheter; coronary angiography; feasibility studies; percutaneous coronary intervention; radial artery; vascular access device

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Radial Artery Cannulation and Transradial Access for Percutaneous Coronary Angiography and Interventions: From Experience to Expertise of a Single Cardiac Centre

Journal of Anesthesia & Clinical Research ◽

10.4172/2155-6148.1000322 ◽

2013 ◽

Vol 04 (05) ◽

Cited By ~ 1

Keyword(s):

Coronary Angiography ◽

Radial Artery ◽

Radial Artery Cannulation ◽

Artery Cannulation ◽

Transradial Access ◽

Percutaneous Coronary ◽

Cardiac Centre

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Effect of Left Versus Right Radial Artery Approach for Coronary Angiography on Radiation Parameters in Patients With Predictors of Transradial Access Failure

The American Journal of Cardiology ◽

10.1016/j.amjcard.2016.05.039 ◽

2016 ◽

Vol 118 (4) ◽

pp. 477-481 ◽

Cited By ~ 8

Author(s):

Binita Shah ◽

Joseph Burdowski ◽

Yu Guo ◽

Bryan Velez de Villa ◽

Andrew Huynh ◽

...

Keyword(s):

Coronary Angiography ◽

Radial Artery ◽

Transradial Access

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Distal transradial access for coronary angiography and interventions in everyday practice: data from the TRIANGLE Registry

European Heart Journal ◽

10.1093/ehjci/ehaa946.2453 ◽

2020 ◽

Vol 41 (Supplement_2) ◽

Author(s):

K Schenke ◽

A Viertel ◽

R Prog ◽

N Joghetaei ◽

T Matthiesen ◽

...

Keyword(s):

Coronary Angiography ◽

Radial Artery ◽

Dorsal Side ◽

High Rate ◽

Puncture Site ◽

Total Occlusion ◽

Coronary Syndrome ◽

Radial Access ◽

Transradial Access ◽

Crossover Rate

Abstract Background Transradial access has become the primary route for coronary angiography (CAG) and percutaneous coronary interventions (PCI). Recently a new puncture site more distally on the dorsal side of the hand in the area of the anatomical snuffbox has been developed. Purpose With this multicenter registry, we wish to demonstrate the feasibility and safety of the distal transradial access (dTRA) and assess the rate of radial artery occlusion (RAO). As an exploratory endpoint, we compared peri-interventional data between right- and left-radial access and differences between the true anatomical snuffbox (SB) and the distal- dorsal (DD) puncture site. Methods Between December 2018 and May 2019 we included all patients into this registry with a planned CAG or PCI via dTRA in three cardiology centers in Germany. Procedural data, puncture success, crossover rate and complications were registered. We examined proximal and distal radial artery patency by ultrasound within 48 h after removal of compression device. Results A total of 327 patients were enrolled (mean age: 69 years, male: 69%), in 5 cases bilateral distal puncture was performed, puncture success was high (N=316/332, 95%) and the crossover rate was low (27/332, 8%). The rate of proximal (2/332) and distal (3/332) RAO was low. Major complications were not encountered. The comparison between SB and DD site and left- and right radial access showed no significant differences (see table). The indication for CAG in 50% of the population was acute coronary syndrome, including 28 patients with ST elevation myocardial infarction (8.4%). Overall PCI rate was 48%. PCI cases did not demonstrate a crossover rate higher than in CAG. PCI on chronic total occlusion (CTO) was performed in 16 cases including bilateral dTRA. Conclusion Coronary angiography and interventions via dTRA can be performed with a high rate of success and safety. This data suggests a reduced rate of RAO compared to previous reported data after cannulation via the standard forearm radial artery puncture site. Randomized studies are needed to further investigate these results. Funding Acknowledgement Type of funding source: None

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Recanalization of the occluded radial artery via distal transradial access in the anatomic snuffbox

BMC Cardiovascular Disorders ◽

10.1186/s12872-021-01890-1 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Feng Li ◽

Gan-Wei Shi ◽

Bi-Feng Zhang ◽

Xiao-Long Yu ◽

Hao-Min Huang ◽

...

Keyword(s):

Percutaneous Coronary Intervention ◽

Coronary Angiography ◽

Radial Artery ◽

Coronary Intervention ◽

Artery Occlusion ◽

Transradial Access ◽

Vascular Ultrasonography ◽

Percutaneous Coronary ◽

Radial Artery Occlusion ◽

The Right

Abstract Background Radial artery occlusion is a common complication after coronary angiography and percutaneous coronary intervention via the transradial access. In recent years, coronary angiography and percutaneous coronary intervention via the distal transradial access has gradually emerged, but recanalization of the occluded radial artery through the distal transradial access has rarely been reported. Case presentation A 67-year-old female with arterial hypertension and diabetes mellitus was admitted to the hospital due to chest pain for three hours. She was diagnosed with acute myocardial infarction. After admission, the patient successfully underwent emergency coronary angiography and percutaneous coronary intervention through the right transradial access. Radial artery occlusion was found after the operation, and recanalization was successfully performed through the right distal transradial access before discharge. Immediately after the operation and one month later, vascular ultrasonography showed that the antegrade flow was normal. Conclusions This report presents a case of radial artery occlusion after emergency coronary angiography and percutaneous coronary intervention in which recanalization was successfully performed through the right distal transradial access. This case demonstrates that recanalization of a radial artery occlusion via the distal transradial access is safe and feasible.

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