Successful stenting of a brachial artery occlusion following surgical retrieval of a twisted diagnostic catheter during transradial coronary angiography

2020 ◽  
Vol 35 (7) ◽  
pp. 1660-1663
Author(s):  
Goktug Savas ◽  
Esra Poyraz ◽  
Yucesin Arslan ◽  
Sait Terzi
Keyword(s):  
Coronary Angiography ◽  
Brachial Artery ◽  
Artery Occlusion ◽  
Diagnostic Catheter

A Case of Aspergillosis Associated with Acute Right Brachial Artery Occlusion by Fungus Granules.

2000 ◽  
Vol 62 (5) ◽  
pp. 632-635
Author(s):  
Sachiko ORIMA ◽  
Yukari MIYAMOTO ◽  
Tsutomu OHTSUKA ◽  
Noriaki HARA ◽  
Akiko BABA ◽  
...  
Keyword(s):  
Brachial Artery ◽  
Artery Occlusion

Atypical presentation of fistula dysfunction due to brachial arterial embolization mimicking stroke

2022 ◽  
pp. 112972982110676
Author(s):  
Rita Vicente ◽  
Laura Rodriguez ◽  
Joaquim Vallespín ◽  
Carolina Rubiella ◽  
Jose Ibeas
Keyword(s):  
Arteriovenous Fistula ◽  
Doppler Ultrasound ◽  
Vascular Access ◽  
Brachial Artery ◽  
Arterial Embolization ◽  
Limb Ischemia ◽  
Artery Occlusion ◽  
Bedside Ultrasound ◽  
Computed Tomographic ◽  
Ultrasound Evaluation

Vascular access thrombosis is an important complication with great impact on access patency and, consequently, on a patient’s quality of life and survival. We report the case of a 73-year-old woman with chronic kidney disease on hemodialysis with a radiocephalic arteriovenous fistula on the right arm that was brought to the emergency department with decreased strength in her right arm, ipsilateral hypoesthesia and facial hemi-hypoesthesia. The patient was given a brain computed tomographic scan that did not confirm suspicion of stroke. On re-examination, the patient had new-onset pain at arteriovenous fistula level, and her right arm was cold and pale. The nephrology department was called for arteriovenous fistula evaluation. On physical examination, her forearm fistula had a decreased thrill and arm elevation exacerbated its paleness. A bedside ultrasound was performed for arteriovenous fistula assessment. Doppler ultrasound revealed: partial thrombosis at brachial bifurcation, a flow of 80–105 mL/min at brachial artery level and a radial artery with a damped waveform. Anastomosis and draining vein were permeable. In this case, the diagnosis of acute embolic brachial artery occlusion was made by a fast bedside ultrasound evaluation. The patient underwent thromboembolectomy with Fogarty technique, recovering fistula thrill, radial and cubital pulses. Thromboembolism of the fistula feeding artery is a rare cause of vascular access thrombosis and it is rarely mentioned in the literature. In this report, failure to recognize the upper limb ischemia would have led to delayed treatment, potentially resulting in the fistula’s complete thrombosis and further limb ischemia. We highlight the importance of a diagnosis method like Doppler ultrasound, which allows for rapid evaluation at the patient’s bedside.

Management of acute brachial artery occlusion due to trauma or emboli

1983 ◽  
Vol 70 (10) ◽  
pp. 639-640 ◽  
Author(s):  
M. Lambert ◽  
C. Ball ◽  
B. Hancock
Keyword(s):  
Brachial Artery ◽  
Artery Occlusion

P2475Method of non-pharmacological recanalization of acute radial artery occlusion after coronary angiography via transradial access

2018 ◽  
Vol 39 (suppl_1) ◽  
Author(s):  
D Ognerubov ◽  
S Provatorov ◽  
E Merkulov ◽  
A Tereshenko ◽  
G Arutyunyan ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Radial Artery ◽  
Artery Occlusion ◽  
Transradial Access ◽  
Radial Artery Occlusion

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.

P6523Radial artery occlusion: predictors, methods for reducing the frequency of complications-a single center study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D Ognerubov ◽  
A Tereshchenko ◽  
E Merkulov ◽  
S Provatorov ◽  
G Arutyunyan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Angiography ◽  
Radial Artery ◽  
Stable Coronary Artery Disease ◽  
Ulnar Artery ◽  
Coronary Intervention ◽  
Artery Occlusion ◽  
Careful Examination ◽  
Radial Access ◽  
Short Time

Abstract Radial access has great advantages in terms of the frequency of complications, but it has one specific complication - radial artery occlusion (RAO). This complication often does not manifest itself in any way; however, it limits the use of access for the future interventions. Aim To compare methods of short and traditional hemostasis and to identify the main predictors of RAO after radial access. Materials and methods During the period from 2012 to 2018, 2000 patients were included in the study, which consisted of two parts: prospective - 1000 patients who underwent coronary angiography and percutaneous coronary intervention (PCI) with stable coronary artery disease, and retrospective part of the study, which included 1000 patients admitted for PCI from other clinics. In a prospective study, patients were divided into two groups: after coronary angiography and PCI, respectively (n=500 in the coronary angiography group and n=500 in the PCI group), and then randomized. Hemostatic bandages in the first group of patients (n=250) were removed after 12–24 hours, in the second group (n=250) - after 4±1 hours. When the occlusion of the radial artery was detected, all patients underwent an hour-long compression of the ipsilateral ulnar artery to recanalize acute RAO. Results The frequency of RAO in the retrospective part of the study was 21.8%. The frequency of RAO in the prospective part of the study was 10.2% with a traditional time hemostasis and 1.4% with a short-time compression (P<0.001). Predictors of the RAO are illustrated in table 1. Predictors of bleeding were PCI (OR 0.12, 95% CI 0.01–0.67, P=0.05) and weight (OR 1.09, 95% CI 1.02–1.18, P=0.01). Table 1. Predictors of RAO Variables Odds ratio 95% Confidential interval Significance, P Traditional-time hemostasis 8.78 4.2–21.5 <0.001 Diabetes mellitus+smoking 18.1 12.7–26.7 <0.001 Diabetes mellitus 0.45 0.25–0.83 0.009 Body mass index 0.95 0.91–0.99 0.02 Male 1.75 1.01–3.18 0.05 Protein C 0,86 0,75–0,96 0,01 Conclusion Careful examination of the patient for detecting RAO before and after interventions is essential. Short hemostasis with compression of the ipsilateral ulnar artery reduce the frequency of RAO. For short-time hemostasis, special attention should be paid to patients after PCI and with low BMI, as far as these factors are associated with a greater risk of bleeding after removal of the compression bandage.

scholarly journals Efficacy and safety of kaolin-based hemostatic pad vs. standard mechanical compression following transradial and transulnar access for elective coronary angiography and PCI: RAUL trial substudy

2019 ◽  
Vol 35 (4) ◽  
pp. 502-508 ◽  
Author(s):  
Lewandowski Pawel ◽  
Gralak-Lachowska Dagmara ◽  
Maciejewski Pawel ◽  
Ramotowski Bogumil ◽  
Budaj Andrzej ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Randomized Trial ◽  
Artery Occlusion ◽  
Efficacy And Safety ◽  
Mechanical Compression ◽  
Single Center ◽  
Analog Scale ◽  
Transradial Approach ◽  
Patient Pain ◽  
Secondary Endpoints

Abstract Hemostatic devices used in the transradial approach (TRA) and transulnar approach (TUA) are limited. This study compared the efficacy and safety of hemostasis using the QuikClot Radial hemostatic pad (QC) vs. standard mechanical compression (SC) after coronary angiography (CAG). This prospective single-center randomized trial included CAG patients. The primary and secondary endpoints were efficacy (successful hemostasis) and safety (total artery occlusion [TAO], pseudoaneurysm, hematoma), respectively. A visual analog scale (VAS) evaluated patient pain during compression. In 2013–2017, 200 patients were randomized 2 × 2 into the: (1) TRA and TUA groups and (2) QC and SC groups. Successful hemostasis was achieved in 92 (92%) patients in the QC group and 100 (100%) patients in the SC group (p < 0.006). The TRA SC subgroup showed significantly better results than the TRA QC subgroup (100% vs. 90.0%; p < 0.03). Similar results were obtained in the TUA QC and TUA SC subgroups (95% vs. 100%; p = 0.5). The secondary endpoint was achieved in the QC and SC groups (8% vs. 9%; p = 0.8). Patients reported significantly less pain during QC application than during SC (VAS: 2.6 ± 2.6 vs. 3.4 ± 2.9; p < 0.03). In patients undergoing CAG with TRA or TUA, QC was associated with lower efficacy, less discomfort, and similar safety compared to SC.

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