Abstract 13877: Comparison of Incidence of Radial Artery Occlusion in Patients Undergoing Trans-radial Intervention With or Without a Sheath: A Prospective Cohort Study

Circulation ◽  
2014 ◽  
Vol 130 (suppl_2) ◽  
Author(s):  
Ghanshyam Palamaner Subash Shantha ◽  
Samir B Pancholy
Keyword(s):  
Radial Artery ◽  
Coronary Intervention ◽  
Artery Occlusion ◽  
Study Cohort ◽  
Diabetes Diagnosis ◽  
Introducer Sheath ◽  
Effect Modifier ◽  
Radial Access ◽  
Percutaneous Coronary ◽  
Radial Artery Occlusion

Introduction: Sheathless transradial access, by decreasing the profile of hardware, is expected to lower the incidence of radial artery occlusion (RAO). Hypothesis: We sought to compare the risk of RAO in patients undergoing coronary intervention with introducer sheath (SG) or without introducer sheath (SLG). Methods: 1251 consecutive patients undergoing 6 French percutaneous coronary intervention (PCI) between January 1, 2009 and December 31, 2013 in Scranton, PA, formed the study cohort. Radial artery patency was assessed using reverse Barbeau’s test and RAO was confirmed by ultrasonography. Unadjusted, adjusted and propensity matched association between type of radial access (SG vs SLG) and RAO were assessed using logistic regression analysis. Results: Mean age was 65 years, 63% were men 37% were diabetics. 78% attained patent hemostasis (PH). Patients in SG had lower pre-discharge RAO [unadjusted (OR: 0.31, 95% CI: 0.21 - 0.46, P < 0.001), adjusted (OR: 0.10, 95% CI: 0.05 - 0.20, P < 0.001) and propensity matched (OR: 0.20, 95% CI: 0.13 - 0.32, P < 0.001)], 24 hours RAO [unadjusted (OR: 0.20, 95% CI: 0.12 - 0.34, P < 0.001), adjusted (OR: 0.12, 95% CI: 0.06 - 0.24, P < 0.001) and propensity matched (OR: 0.13, 95% CI: 0.07 - 0.25, P < 0.001)] and 30 day RAO [unadjusted (OR: 0.28, 95% CI: 0.14 - 0.54, P < 0.001), adjusted (OR: 0.22, 95% CI: 0.10 - 0.50, P < 0.001) and propensity matched (OR: 0.18, 95% CI: 0.10 - 0.40, P < 0.001)], compared to those in SLG. Spontaneous recanalization rates were significantly higher in SG compared to SLG at 24 hours (62% Vs 38%, P = 0.007) but similar at 30 days (38% Vs 50%, P = 0.338) post PCI. Diabetes diagnosis was an effect modifier for RAO at pre-discharge, 24 hours and 30 days post PCI. Conclusions: Sheath use during radial access for PCI, despite diametrically increasing hardware profile, is associated with less RAO, likely by reducing friction induced intimal trauma. Diabetes is an effect modifier in this association.

Feasibility of Distal Radial Access for Coronary Angiography and Percutaneous Coronary Intervention: A Single Center Experience

Cardiology ◽  
2021 ◽  
pp. 1-7
Author(s):  
Lianna Xie ◽  
Xianjing Wei ◽  
Zezhou Xie ◽  
Shengying Jia ◽  
Siwei Xu ◽  
...  
Keyword(s):  
Radial Artery ◽  
Interventional Procedure ◽  
Coronary Intervention ◽  
Artery Occlusion ◽  
Artery Cannulation ◽  
St Segment Elevation ◽  
Radial Access ◽  
St Segment ◽  
Percutaneous Coronary ◽  
Radial Artery Occlusion

<b><i>Objective:</i></b> Asymptomatic radial artery occlusion remains the most common complication in transradial coronary interventional procedure. To prevent radial artery occlusion, distal transradial access (dTRA) has been suggested recently. In this article, we aim to describe our experience and to assess feasibility and safety of this new access site for routine coronary angiography (CAG) and percutaneous coronary intervention (PCI). <b><i>Methods:</i></b> We retrospective analyzed 1,063 consecutive patients who were assigned to undergo CAG or procedural PCI through dTRA between 1 January 2018 and 31 December 2019 at Affiliated Zhongshan Hospital of Dalian University. The size of radial sheath used was 5 or 6 French. The sheath was removed at procedure termination, and hemostasis was obtained by compression bandage with gauze. The success rate of dTRA access defined by successful radial artery cannulation on the first dTRA side attempted, the cause of access failure, the hemostasis duration, the incidence of post-catheterization radial artery occlusion, and the other access-related complications including hematoma of forearm and thumb numbness were assessed. <b><i>Results:</i></b> Radial artery cannulation via dTRA was successful in 953 of 1,063 patients with a success rate of 89.7%. Mean age of successful cases was 64.6 ± 11.2 years (26–94 years) with 339 (35.6%) women. A total of 363 (38.1%) cases were PCI. Among them, 95 cases (10%) underwent urgent PCI, including primary PCI in 64 patients with ST-segment elevation myocardial infarction and immediate PCI (&#x3c;2 h from hospital admission) in 31 patients with very high-risk non-ST-segment elevation acute coronary syndrome. A total of 269 (28.2%) cases were via left dTRA. The 6 French sheath was used in 602 (63.2%) cases. Hemostasis was obtained within 2 h in 853 (89.5%) patients. There were 110 (10.3%) procedural failures: 59 (5.6%) cases of artery puncture failure, 49 (4.9%) cases of guide wire insertion failure, and 2 (0.2%) cases of sheath insertion failure. Complications potentially related to distal radial access included radial artery occlusion at the access site (13 cases, 1.4%), forearm radial artery occlusion (4 cases, 0.4%), hematoma of forearm (5 cases, 0.5%), and transient thumb numbness (2 cases, 0.2%). <b><i>Conclusion:</i></b> dTRA is a feasible and safe access and can be used as a rational alternative to traditional radial access for routine coronary interventional procedure.

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.

Radial Artery Occlusion after Percutaneous Coronary Intervention through Transradial Approach

2021 ◽  
Vol 15 (8) ◽  
pp. 2246-2249
Author(s):  
Muhammad Asif Farooqi ◽  
Bilal Rafique Malik ◽  
Rehan Anwar
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Radial Artery ◽  
Coronary Intervention ◽  
Artery Occlusion ◽  
Good Opportunity ◽  
Transradial Approach ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Radial Artery Occlusion

Introduction: Radial artery occlusion may occur after percutaneous coronary intervention when done via transradial approach. The frequency of radial artery occlusion is almost nil in patients after PCI through transradial approach. Thus radial artery approach for PCI can be a good opportunity to conduct the procedure. Objective: To assess the frequency of radial artery occlusion after percutaneous coronary intervention through transradial approach in patients of acute coronary syndrome Material & Methods Study Design: Descriptive case study Settings: Department of Cardiology, Punjab Institute of Cardiology, Lahore. Duration: Six months i.e. 1st July 2020 to 31st December 2020. Data Collection: Total 100 patients who underwent PCI through transradial approach 6 months ago were studied. All the selected patients then underwent Doppler scan to assess patency of radial artery. Radial artery occlusion was confirmed by when there was reduced flow in radial artery as compared to the adjacent side artery Results: In this study, the mean age of patients was 54.56 ± 8.96 years. There were 43 (43%) males and 57 (57%) females. The frequency of radial artery occlusion in patients after PCI through transradial approach was seen in 3 (3%) of the patients. Conclusion: Results of this study demonstrates that the frequency of radial artery occlusion is almost nil in patients after PCI through transradial approach. Thus radial artery approach for PCI can be a good opportunity to conduct the procedure. Key Words: Radial artery Occlusion, Transradial approach, percutaneous coronary intervention, acute coronary syndrome

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