scholarly journals Routine snuffbox approach do not reduce radial artery occlusion in comparison with conventional transradial access

2021 ◽  
Vol 42 (Supplement_1) ◽  
Author(s):  
L Kozinski ◽  
A Dabrowska-Kugacka ◽  
Z Orzalkiewicz
Keyword(s):  
Radial Artery ◽  
Hemodynamic Instability ◽  
Artery Occlusion ◽  
Similar Frequency ◽  
Funding Sources ◽  
Transradial Access ◽  
St Elevation ◽  
Coronary Procedures ◽  
Radial Artery Occlusion

Abstract Background/Introduction Postprocedural radial artery occlusion (RAO) is still the Achilles' heel of conventional transradial approach (cTRA) as it limits its reuse for future coronary procedures. A distal transradial access (dTRA) via the anatomical snuffbox has been proposed as an alternative. It is hypothesised that dTRA may reduce the incidence of RAO. Purpose To assess whether routine dTRA reduce the risk of RAO in consecutive patients undergoing coronary angiography or intervention, in comparison with cTRA. Methods Out of 465 subjects, 400 patients were included in a prospective, single-center, randomized (1:1) study. Hemodynamic instability, ST-elevation myocardial infarction, forearm artery occlusion or prior radial access failure were the exclusion criteria. Ultrasound-guided follow-up was obtained after 1 day and 60 days to evaluate the incidence of acute and late RAO. Results Baseline characteristics of patients were matched. Results are presented in table 1. Conclusion(s) The incidence of postprocedural acute and late RAO after routine dTRA and cTRA is low and occur with similar frequency when evaluated by ultrasound. FUNDunding Acknowledgement Type of funding sources: None. Table 1

scholarly journals A Randomized Trial Comparing Short versus Prolonged Hemostasis with Rescue Recanalization by Ipsilateral Ulnar Artery Compression: Impact on Radial Artery Occlusion—The RESCUE-RAO Trial

2020 ◽  
Vol 2020 ◽  
pp. 1-7
Author(s):  
Dmitrii V. Ognerubov ◽  
Alexander Sedaghat ◽  
Sergey I. Provatorov ◽  
Andrey S. Tereshchenko ◽  
Olivier F. Bertrand ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Randomized Trial ◽  
Hospital Discharge ◽  
Radial Artery ◽  
Ulnar Artery ◽  
Artery Occlusion ◽  
Puncture Site ◽  
Coronary Procedures ◽  
Baseline Characteristics ◽  
Radial Artery Occlusion

Background. Despite the enormous benefits of radial access, this route is associated with a risk of radial artery occlusion (RAO). Objective. We compared the incidence of RAO in patients undergoing transradial coronary angiography and intervention after short versus prolonged hemostasis protocol. Also we assessed the efficacy of rescue 1-hour ipsilateral ulnar artery compression if RAO was observed after hemostasis. Material and Methods. Patients referred for elective transradial coronary procedures were eligible. After 6 F radial sheath removal, patients were randomized to short (3 hours) (n = 495) or prolonged (8 hours) (n = 503) hemostasis and a simple bandage was placed over the puncture site. After hemostasis was completed, oximetry plethysmography was used to assess the patency of the radial artery. Results. One thousand patients were randomized. Baseline characteristics were similar between both groups with average age 61.4 ± 9.4 years (71% male) and PCI performed on half of the patients. The RAO rate immediately after hemostasis was 3.2% in the short hemostasis group and 10.1% in the prolonged group ( p < 0.001 ). Rescue recanalization was successful only in the short group in 56.2% (11/19); at hospital discharge, RAO rates were 1.4% in the short group and 10.1% in the prolonged group ( p < 0.001 ). Conclusion. Shorter hemostasis was associated with significantly less RAO compared to prolonged hemostasis. Rescue radial artery recanalization was effective in > 50%, but only in the short hemostasis group.

scholarly journals Comparison of transradial coronary intervention for left main bifurcation disease using the new Braidin® slender 7 Fr sheath and a standard 6 Fr sheath

2020 ◽  
Vol 48 (9) ◽  
pp. 030006052095472
Author(s):  
Yingkai Xu ◽  
Yingkai Li ◽  
Jiancai Yu ◽  
Deguang Wang ◽  
Qi Zhao ◽  
...  
Keyword(s):  
Radial Artery ◽  
Multivariate Logistic Regression Analysis ◽  
Operation Time ◽  
Coronary Intervention ◽  
Artery Occlusion ◽  
Left Main ◽  
Percutaneous Coronary ◽  
Occlusion Rate ◽  
Radial Artery Occlusion

Objectives To compare the effectiveness and safety of the Braidin® slender 7 Fr sheath with a standard 6 Fr sheath for treating left main bifurcation disease. Methods From January 2017 to March 2019, 277 patients with left main bifurcation disease who underwent the transradial approach for percutaneous coronary intervention were divided into the slender 7 Fr sheath group (Braidin® slender 7 Fr sheath, n = 154) and standard 6 Fr sheath group (n = 123). Pathological features, surgical effect, and complications were evaluated. Results The rate of using the classic crush technique was significantly higher in the slender 7 Fr sheath group than in the standard 6 Fr sheath group. The slender 7 Fr sheath group had a significantly shorter operation time than the standard 6 Fr sheath group. There were no significant differences in the radial artery occlusion rate after surgery and at 1 month of follow-up between the groups. Multivariate logistic regression analysis showed that 6 Fr and Braidin slender 7 Fr sheaths did not predict radial artery occlusion. Conclusion The Braidin slender 7 Fr sheath has a superior operative process and similar safety for the radial artery as that of the standard 6 Fr sheath for treating left main bifurcation disease.

Abstract 14147: Vascular Complication of Distal Transradial Approach in Patients With Acute Myocardial Infarction

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Takeshi Yamada ◽  
Yuki Matsubara ◽  
Soichiro Washimi ◽  
Sho Hashimoto ◽  
Norimasa Taniguchi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Radial Artery ◽  
Bleeding Complication ◽  
Artery Occlusion ◽  
Vascular Complication ◽  
Primary Pci ◽  
Transradial Approach ◽  
The Mean ◽  
Radial Artery Occlusion

Background: The distal transradial approach (dTRA) for coronary catheterisation is a newly introduced alternative to the conventional transradial approach. This study investigated the incidence of vascular complication of the dTRA in patients with acute myocardial infarction (AMI) who underwent primary percutaneous coronary intervention (PCI). Methods: Consecutive 131 patients with AMI who underwent primary PCI between April 2018 and October 2019 were investigated. The dTRA was used as the primary approach whenever feasible in this study period. The bleeding complication after dTRA and the patency of the radial artery were investigated. The patency of the radial artery was examined using Doppler ultrasound in follow-up period. Results: Among the 131 AMI patients, 116 patients (88.5%) underwent successful primary PCI using the dTRA. The patients included 83 men (71.6%), and the mean age was 70.4 ± 12.9 years. A 5- or 6-French sheath (conventional or slender) was used in the primary procedure. The average time to achieving hemostasis was 5.0 ± 4.1 hours; TIMI minor bleeding was observed in 2 patients (1.5%) and there were no TIMI major bleeding. Color Doppler sonography of the radial artery was performed in 94 patients with the mean follow-up period of 273 ± 183 days, and the incidence of radial artery occlusion (RAO) was 1.1% (n=1). Conclusions: The application of dTRA is considered to have low incidences of bleeding complication and radial artery occlusion in the patients with AMI.

Radial artery occlusion and hand strength after percutaneous coronary procedures: Results of the HANGAR study

2015 ◽  
Vol 87 (5) ◽  
pp. 868-874 ◽  
Author(s):  
Alessandro Sciahbasi ◽  
Stefano Rigattieri ◽  
Alessandro Sarandrea ◽  
Maria Cera ◽  
Cristian Di Russo ◽  
...  
Keyword(s):  
Radial Artery ◽  
Artery Occlusion ◽  
Hand Strength ◽  
Percutaneous Coronary ◽  
Coronary Procedures ◽  
Radial Artery Occlusion
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