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.

P1761Distal transradial approach for primary percutaneous coronary intervention for patients with acute myocardial infarction: a multicentre study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Izumikawa ◽  
S Takeshita ◽  
T Yamada ◽  
Y Mizuguchi ◽  
N Taniguchi ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Acute Myocardial Infarction ◽  
Percutaneous Coronary Intervention ◽  
Radial Artery ◽  
Coronary Intervention ◽  
Primary Pci ◽  
Transradial Approach ◽  
Percutaneous Coronary ◽  
The Mean ◽  
Distal Radial Artery

Abstract Background The distal transradial approach (dTRA) for coronary catheterisation is a newly introduced alternative to the conventional transradial approach. This technique is expected to decrease the incidence of haemorrhagic complications and improve patient comfort. However, limited data are available regarding the application of this technique in patients with acute myocardial infarction (AMI). This study investigated the feasibility and safety of the dTRA for primary percutaneous coronary intervention (PCI) in patients with AMI. Methods This study included patients with AMI who underwent primary PCI via the distal radial artery across 3 Japanese hospitals between January 2018 and January 2019. Patients' background, procedural characteristics, and clinical outcomes including the incidence of haemorrhagic complications were analysed. Results This study enrolled 95 consecutive patients with AMI, including 68 patients (71.6%) with ST-segment elevation myocardial infarction (STEMI), in whom distal radial artery puncture was attempted for primary PCI. The patients included 70 men (73.7%), and the mean age was 72.2±12.4 years. Among these patients, cannulation was successfully performed in 89 patients (93.7%). A 5-, 6-, or 7-French sheath (conventional or slender) was used in this study. Cannulation was performed using a forearm radial artery approach in patients in whom dTRA failed. PCI was successfully performed in all patients. The meantime to achieve haemostasis was 6.3±5.3 hours, and no major bleeding complications occurred. Based on The Early Discharge After Transradial Stenting of Coronary Arteries trial haematoma scale, grade I, II, and III subcutaneous haemorrhages were observed in 16 (16.8%), 4 (4.2%), and 1 patient (1.1%), respectively. No patient developed a haematoma > grade IV. In patients with STEMI, the mean door-to-balloon time was 39.4±31.9 min, and the mean puncture-to-balloon time was 19.7±14.2 min. Conclusions The distal radial approach is feasible and safefor primary PCI in selected patients with AMI.The application of the dTRA may serve as a less invasive strategy for the treatment of patients with AMI.

scholarly journals Post-procedural radial artery occlusion and patency detection using duplex ultrasound vs. the reverse Barbeau test

2020 ◽  
Vol 22 (Supplement_F) ◽  
pp. F23-F29
Author(s):  
Stepan Jirous ◽  
Ivo Bernat ◽  
David Slezak ◽  
Roman Miklik ◽  
Richard Rokyta
Keyword(s):  
Radial Artery ◽  
Duplex Ultrasound ◽  
Artery Occlusion ◽  
Duplex Ultrasonography ◽  
Transradial Approach ◽  
Local Complications ◽  
Compression Time ◽  
First Choice ◽  
Same Day Discharge ◽  
Radial Artery Occlusion

Abstract The transradial approach is recommended as a first choice in coronary catheterizations and interventions, for among other reasons, the reduction in the number of local complications. A head-to-head comparison of the reverse Barbeau test (RBT) and duplex ultrasonography (DUSG) for the detection of post-procedural radial artery patency and occlusion has not yet been evaluated. In 500 patients from our same-day discharge program (age 65 ± 9.4 years, 148 women), radial artery patency and occlusion, compression time, haematomas, and other local complications were evaluated. Radial artery patency was confirmed in 495 patients (99.0%), and complete radial artery occlusion (RAO) was detected in 2 (0.4%) patients using both methods. In 3 patients (0.6%), the RBT was negative, while incomplete RAO was detected by DUSG. Superficial haematomas (˃ 5 but ≤10 cm) were found in 27 (5.4%) patients. There were no other local complications. Detection of radial artery patency and occlusion using the RBT and DUSG was comparable. The incidence of RAO in our study was extremely low. Thanks to its simplicity, the RBT has the potential to be used as the first method of detection of radial occlusion after coronary catheterizations.

scholarly journals Safety and feasibility of the distal transradial approach: A novel technique for diagnostic cerebral angiography

2020 ◽  
Vol 26 (6) ◽  
pp. 713-718
Author(s):  
Shoji Saito ◽  
Hitoshi Hasegawa ◽  
Tomoyoshi Ota ◽  
Toru Takino ◽  
Yuichi Yoshida ◽  
...  
Keyword(s):  
Radial Artery ◽  
Cerebral Angiography ◽  
Artery Occlusion ◽  
Transradial Approach ◽  
Novel Technique ◽  
Ultrasound Evaluation ◽  
The Mean ◽  
Cannulation Success Rate ◽  
Cannulation Success ◽  
Distal Radial Artery

Purpose We aimed to evaluate the safety and feasibility of the distal transradial approach (DTRA) as a novel technique for cerebral angiography based on our institutional initial experience. Methods We retrospectively analyzed our institutional database of consecutive diagnostic cerebral angiographies performed with DTRA from December 2018 to August 2019. Patient demographics and clinical and procedural data were recorded. Results In total, 51 diagnostic cerebral angiographies in 51 patients (age, 15–83 years; mean age, 59.4 years, SD 13.5; 35 (69%) females) were performed or attempted with DTRA. Ultrasound evaluation showed that the mean inner distal radial artery diameter was significantly smaller than the mean inner forearm radial artery diameter (2.19 mm vs. 2.56 mm, P < 0.001). Cannulation via the distal radial artery was successful in 47 (92%) procedures. In the four procedures that failed, operators converted to the ipsilateral transradial approach without repositioning or redraping. Selective catheterization of the intended vessel was achieved in 64 (91%) of 70 vessels. In the remaining six, operators achieved the objective of the examination with angiography injecting from proximal and conversion to another approach was not required. One patient experienced temporary numbness around the puncture site after the procedure. No radial artery occlusion was identified in the patients who underwent ultrasound evaluation. Conclusion Our results demonstrate that DTRA could become a standard approach for diagnostic cerebral angiography owing to the low complication rate and the high cannulation success rate.

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.

scholarly journals Metode Barbeau Test dalam Menilai Keutuhan Arteri Radialis Pascaintervensi Koroner Perkutan

1970 ◽  
Vol 2 (1) ◽  
Author(s):  
Nurhusna N ◽  
F Sri Susilaningsih ◽  
Purwo Suwigjo
Keyword(s):  
Radial Artery ◽  
Cardiac Catheterization ◽  
Quantitative Research ◽  
Clinical Observation ◽  
Vascular Complications ◽  
Artery Occlusion ◽  
Vascular Complication ◽  
Test Method ◽  
Significant Difference ◽  
Radial Artery Occlusion

Radial artery occlusion merupakan salah satu komplikasi vaskular postkateterisasi jantung trans radial. Kompresi lokal menggunakan alat kompresi setelah tindakan kateterisasi jantung trans radial dapat menurunkan angka kejadian komplikasi vaskular Radial Artery Occlusion(RAO). Penelitian ini bertujuan untuk mengetahui perbandingan antara metode Barbeau test dan metode pengamatan klinik dalam menilai keutuhan arteri radialis selama proses kompresi pada pasien postprosedur kateterisasi jantung trans radial. Penelitian ini merupakan penelitian kuantitatif dengan desain studi komparatif. Subjek penelitian adalah 20 pasien yang menjalani prosedur kateterisasi jantung dengan akses arteri radialis. Pengukuran dilakukan secara bertahap menit ke-15 dan setelah tiga jam menggunakan alat kompresi stepty-p. Uji komparasi menggunakan uji McNemar. Data univariat dianalisis menggunakan distribusi frekuensi. Hasil uji statistik menunjukkan ada perbedaan penilaian keutuhan arteri radialis antara metode Barbeau testdengan metode pengamatan klinik pada menit ke-15 (p=0.035) dan ke-30 (p=0.035). Namun secara keseluruhan hasil uji statistik menunjukkan tidak ada perbedaan yang bermakna dalam menilai kepatenan arteri pada setiap waktu pengamatan dari kedua metode. Kata kunci:Arteri radialis, Barbeau test, kateterisasi jantung, keutuhan, pengamatan klinik AbstractRadial artery occlusion is one of the trans radial vascular complications post cardiac catheterization. The local compression using compression methods after cardiac catheterization can be reduced the vascular complication such as radial artery occlusion (RAO). This research was conducted to determine the comparison between the Barbeau test method and the clinical observation method carried out by the researcher in order to examine the patency of radial artery during compression, post procedure cardiac catheterization at the Angiography Coroner Unit and the Cardiac Intensive Care Unit, Hasan Sadikin Bandung General Hospital, Indonesia. This research was a quantitative research using the comparative study design. The subjects were 20 patients who took cardiac catheterization procedure using radial artery access and checked in pairs. The measurement divided into two periods: the fifteenth minute and the third hour using the stepty-p compression tool. The statistical test used the McNemar test to analyze the comparison, and the single variable data were analyzed using the distribution frequency. There were a significant difference in radial artery evaluation during compression period between two methods, in which at the first fifteen minutes (p=0.035) and the first thirty minutes (p=0.035), respectively. Overall, the result shows that there were no significant difference in comparison of two methods. Key words:Barbeau test, cardiac catheterization, clinical observation, patency, radial artery

scholarly journals Frequency and Predictors of Radial Artery Occlusion after Coronary Procedure through Transradial Approach: A Vascular Doppler-guided Study

2019 ◽  
Vol 34 (2) ◽  
pp. 111-117
Author(s):  
Mohammad Abdul Matin ◽  
Mir Jamal Uddin ◽  
Abdul Momen ◽  
Mustafizul Aziz ◽  
Abeeda Tasnim Reza ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Radial Artery ◽  
Univariate Analysis ◽  
Multivariate Logistic Regression Analysis ◽  
Vascular Complications ◽  
Artery Occlusion ◽  
Transradial Approach ◽  
Doppler Study ◽  
Coronary Procedure ◽  
Radial Artery Occlusion

Background: Although transradial approach (TRA) has better outcome and reduced vascular complications, radial artery occlusion (RAO) is now a major concern as it limits future radial artery use for further TRA, for use as a conduit during CABG, for invasive hemodynamic monitoring and for creation of arteriovenous fistula for hemodialysis in CKD patients. Vascular doppler study is the most accurate method for evaluation of RAO and yet this is not practiced in our population. Objectives: To detect the frequency and identify the predictors of RAO after coronary procedure through TRA. Methods: This cross-sectional analytical study was done in the department of cardiology, NICVD from July-2015 to June- 2016 by including a total 125 patients undergoing coronary procedures (CAG and/or PCI) through TRA. Vascular doppler study of the radial artery were performed before and one day after the procedure. RAO was defined as an absence of antegrade flow and monophasic flow on doppler study. Univariate and multivariate logistic regression analysis were done to evaluate the predictors of RAO. Results: On the day after the procedure, radial artery vascular doppler examination revealed RAO in 12 (09.6%) patients. On univariate analysis female gender (p= 0.038), diabetes mellitus (p= 0.024), prolonged hemostatic compression for more than 02 hours after sheath removal (p= 0.003) were identified as predictors of RAO. Interestingly hypertension, low BMI, smaller radial artery diameter and use of reprocessed sheath were not identified as predictors of RAO. On multivariate analysis diabetes mellitus (p= 0.016), prolonged hemostatic compression for more than 02 hours after sheath removal (p= 0.004) were found as independent predictors for RAO. Conclusion: Frequency of RAO was 09.6% after coronary procedure through TRA. Diabetes mellitus and hemostatic compression after sheath removal for more than two hours were identified as independent predictors of RAO. Strategies should be taken from patient selection for TRA to end of hemostatic compression removal to prevent RAO. Bangladesh Heart Journal 2019; 34(2) : 111-117

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

scholarly journals Evaluation of radial artery occlusion in patients undergoing diagnostic and therapeutic coronary procedures via distal radial access. A retrospective observational study (RDISTAL DOR)

2021 ◽  
Vol 29 ◽  
pp. 1-7
Author(s):  
Marden Tebet ◽  
Mickael Ogama ◽  
Sergio Kreimer ◽  
Eduardo Santos ◽  
Pedro Andrade ◽  
...  
Keyword(s):  
Doppler Ultrasound ◽  
Radial Artery ◽  
Diagnostic Procedures ◽  
Artery Occlusion ◽  
Vascular Complication ◽  
Medical Community ◽  
Coronary Syndrome ◽  
Radial Access ◽  
Coronary Procedures ◽  
Radial Artery Occlusion

Background: The use of the distal radial access for invasive coronary procedures has been rapidly adopted by the medical community, but with no evaluation of efficacy and safety outcomes of this approach. The objective was to evaluate the rate of radial artery occlusion involved in this technique, using Doppler ultrasound. Methods: This was an observational, retrospective study involving patients undergoing invasive diagnostic or therapeutic coronary procedures via distal radial access, with assessment of the radial artery patency by Doppler ultrasound. The primary outcome analyzed was the rate of radial artery occlusion. Results: Between July and December 2020, 51 patients underwent procedures via distal radial access, with assessment of the radial artery patency, out of a total of 603 patients seen during this period. Patients were aged 58±10.8 years, 68.6% were male, 26.9% had diabetes mellitus, and 68.6% were diagnosed with acute coronary syndrome. Diagnostic procedures were performed in 68.2% of sample, and 23.5% of patients had undergone a previous use of the ipsilateral proximal radial access. Doppler ultrasound was performed over a mean period of 24 hours, and no occlusion of the radial artery was observed, with mean time for sheath insertion of 1.9 minutes. There was no major vascular complication. In two patients, pain was observed at the access point; another two had a small subcutaneous hematoma, and, one patient, presented with moderate spasm. Conclusion: The use of distal radial access was associated with a low rate of hemorrhagic complications in the access route, and absence of occlusion of the radial artery by Doppler ultrasound assessment.

scholarly journals Outcome of Elderly Population Undergoing Primary PCI in a Tertiary Hospital in Bangladesh

2021 ◽  
Vol 10 (1-2) ◽  
pp. 18-26
Author(s):  
Sahela Nasrin ◽  
Shitil Ibna Islam ◽  
F Aaysha Cader ◽  
M Maksumul Haq
Keyword(s):  
Myocardial Infarction ◽  
Cardiovascular Events ◽  
Left Ventricular ◽  
Advanced Age ◽  
Left Ventricular Ejection ◽  
Primary Pci ◽  
Female Ratio ◽  
Vessel Disease ◽  
The Mean

Objective: To evaluate in-hospital and 1-year outcomes of primary percutaneous coronary intervention (PPCI) in elderly patients with ST-elevation myocardial infarction (STEMI). Methods: All patients aged ≥ 65 years presenting with STEMI and undergoing PPCI at Ibrahim Cardiac Hospital & Research Institute, Bangladesh from January 2015 to August 2017 were consecutively included in the study based on predefined eligibility criteria. Data pertaining to angiographic characteristics, procedural variables, in-hospital and 1-year outcome variables were recorded and analyzed with the help of descriptive statistics and Chi-square Test. Results: The mean age of the patients was 69.2 ± 5.2 (range: 65-85) years with male to female ratio being 4:1. The patients were predominantly diabetic (78%) followed by hypertensive (74%) and dyslipidaemic (70%) smoker (54%). Half of the patients presented with anterior myocardial infarction (MI), 30% had inferior MI, 12% with right ventricular (RV) extension and 8% with inferolateral extension. About one-quarter (24%) had arrhythmia with complete heart block (CHB). The culprit arteries were LAD (50%), followed by RCA (42%) and LCx (8%). Nearly half (46%) had single vessel disease, 34% double and 20% triple vessel disease. Majority (80%) received a single stent and 20% required two stents with mean diameter and length of the stents were 2.9 ± 0.4 mm and 27.3 ± 7.9 mm respectively. Intracoronary eptifibatide was used in 20% cases. In terms of left ventricular ejection fraction (LVEF), 58% and 28% had mild and moderate LV systolic dysfunction respectively. The mean duration of hospital stay was 4.0 ± 1.9 days. About 18% required repeat hospitalization. Overall, 7(14%) patients died (4 during their stay in the hospital due to cardiac cause and 3 during follow up due to non-cardiac causes). At 1 year follow up, in-stent restenosis was seen in 1 case followed by target vessel revascularization (TVR). The Association between age and outcome revealed that advanced age (age ≥ 75 years) was an important predictor of in-hospital and one-year outcome with Relative Risk (RR) of having unfavorable outcome was > 5-fold (95% CI: 1.6-19.5) in patients of advanced age than that in patients of age < 75 years (p = 0.008). Conclusion: Primary PCI is a feasible treatment option for elderly Bangladeshi patients presenting with STEMI with fewer in-hospital and 1-year follow up deaths. Adverse cardiovascular events are even less. Advanced age (age ≥75 years) is an important determinant of adverse cardiovascular events including mortality, probably because of more medical co-morbidities associated with advanced age. Ibrahim Card Med J 2020; 10 (1&2): 18-26

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