Vascular Complications of Transradial Access for Cardiac Catheterization

Transradial access has been increasingly adopted for cardiac catheterization. It is crucial for operators to recognize potential vascular complications associated with radial artery access. Prevention, early detection, and prompt treatment of vascular complications are essential to prevent serious morbidities. This review aims to raise awareness of transradial access vascular complications. Radial artery spasm is treated with intra-arterial verapamil and/or nitroglycerine. Hemorrhagic complications, such as perforation, hematoma, arteriovenous fistula, and pseudoaneurysm, are treated with prolonged compression. Patent hemostasis and adequate anticoagulation are used to prevent radial artery occlusion. Hand ischemia is a rare complication not associated with abnormal results of the Allen or Barbeau test, and can be treated with intra-arterial verapamil, IV heparin, and IV diltiazem. Finally, an attentive monitoring protocol for the timely detection of vascular complications should be implemented in daily practice.

Download Full-text

Pseudoaneurysm a rare complication of transradial cardiac catheterization: a case report

Vascular ◽

10.1177/1708538113478745 ◽

2013 ◽

Vol 21 (5) ◽

pp. 331-334 ◽

Cited By ~ 1

Author(s):

Tariq Bhat ◽

Hilal Bhat ◽

Sumaya Teli ◽

Bartaula Rajiv ◽

Muhammad Akhtar ◽

...

Keyword(s):

Radial Artery ◽

Cardiac Catheterization ◽

Rare Complication ◽

Arterial Occlusion ◽

Surgical Excision ◽

Artery Occlusion ◽

Transfemoral Approach ◽

Radial Artery Occlusion ◽

Viable Approach

Transradial access for cardiac catheterization is a safe and viable approach with significantly lower incidence of major access-related complications compared with the transfemoral approach. As this form of access is getting wider acceptance among interventional cardiologists, awareness of its complications is of vital importance. Asymptomatic radial artery occlusion, non-occlusive radial artery injury and radial artery spasm are commonly reported complication of this approach. Symptomatic radial arterial occlusion, pseudoaneurysm and radial artery perforation are rarely reported complications of transradial approach. Early identification of these uncommon complications and their urgent management is of significant importance. We present the case of an 80-year-old lady who developed pseudoaneurysm a week after transradial cardiac catheterization managed with surgical excision with no long-term sequela.

Download Full-text

Metode Barbeau Test dalam Menilai Keutuhan Arteri Radialis Pascaintervensi Koroner Perkutan

Jurnal Keperawatan Padjadjaran ◽

10.24198/jkp.v2i1.82 ◽

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

Download Full-text

The frequency of radial artery occlusion following cardiac catheterization with the use of transradial pneumatic compression band

BMC Research Notes ◽

10.1186/s13104-020-05323-8 ◽

2020 ◽

Vol 13 (1) ◽

Author(s):

Kashif Ali Hashmi ◽

Zahid Iqbal ◽

Atif Ali Hashmi ◽

Maira Shoaib ◽

Muhammad Irfan ◽

...

Keyword(s):

Diabetes Mellitus ◽

Radial Artery ◽

Cardiac Catheterization ◽

Age Groups ◽

Vascular Complications ◽

Artery Occlusion ◽

Study Cohort ◽

Coronary Catheterization ◽

Significant Difference ◽

Radial Artery Occlusion

Abstract Objectives Radial artery occlusion is a silent complication of a transradial approach to cardiac catheterization that may complicate subsequent transradial procedures in patients undergoing cardiac catheterization. A transradial band reduces vascular complications and provides brisk, powerful and effective haemostasis. The purpose of this study was to assess the frequency of radial artery occlusion in 180 patients undergoing transradial coronary catheterization. Results The median age of the study cohort was 58 years. Radial artery occlusion was found in 14 (7.8%) patients. When stratifying by age group and sex, there was no significant difference in radial artery occlusion between age groups and sex. It was likewise found that comorbidities such as diabetes mellitus, hypertension and smoking, increased the risk of radial artery occlusion however this was observed to be significant only for diabetes mellitus. We therefore conclude that a transradial pneumatic pressure band is an extremely helpful and safe strategy to prevent radial artery occlusion.

Download Full-text

Frequency of radial artery occlusion with transradial pneumatic compression band after cardiac catheterization

10.21203/rs.3.rs-42637/v1 ◽

2020 ◽

Author(s):

Kashif Ali Hashmi ◽

Zahid Iqbal ◽

Atif Ali Hashmi ◽

Maira Shoaib ◽

Muhammad Irfan ◽

...

Keyword(s):

Diabetes Mellitus ◽

Radial Artery ◽

Cardiac Catheterization ◽

Age Groups ◽

Vascular Complications ◽

Artery Occlusion ◽

Study Cohort ◽

Coronary Catheterization ◽

Significant Difference ◽

Radial Artery Occlusion

Abstract Objectives Radial artery occlusion is a silent complication of a transradial approach to cardiac catheterization that may complicate subsequent transradial procedures in patients undergoing cardiac catheterization. A transradial band reduces vascular complications and provides brisk, powerful and effective haemostasis. The purpose of this study was to assess the frequency of radial artery occlusion in 180 patients undergoing transradial coronary catheterization.Results The mean age of the study cohort was 54.19 ± 12.30 years. Radial artery occlusion was found in 14 (7.8%) patients. When stratifying by age group and sex, there was no significant difference in radial artery occlusion between age groups and sex. It was likewise found that comorbidities such as diabetes mellitus, hypertension and smoking, increased the risk of radial artery occlusion however this was observed to be significant only for diabetes mellitus. We therefore conclude that a transradial pneumatic pressure band is an extremely helpful and safe strategy to prevent radial artery occlusion.

Download Full-text

Radial artery occlusion after cardiac catheterization and impact of medical treatment

VASA ◽

10.1024/0301-1526/a000892 ◽

2020 ◽

Vol 49 (6) ◽

pp. 463-466

Author(s):

Martin Steinmetz ◽

Tobias Radecke ◽

Tomasz Boss ◽

Max J. Stumpf ◽

Julia Lortz ◽

...

Keyword(s):

Retrospective Analysis ◽

Radial Artery ◽

Cardiac Catheterization ◽

Rare Complication ◽

Bypass Graft ◽

Artery Occlusion ◽

Tertiary Referral Hospital ◽

Radial Artery Occlusion ◽

Transradial Catheterization

Summary: Background: The transradial artery approach is the preferred access for cardiac catheterization according to current guidelines. However, the most common complication is radial artery occlusion (RAO). Despite the rare indication for surgical reopening, the occluded radial artery is not available for further procedures or as a potential bypass graft. Still, treatment regimens for RAO are scarce. We now determined whether the addition of antithrombotic to antiplatelet therapy improves the rate of partial or complete regain of patency in RAO following transradial cardiac catheterization in a retrospective analysis. Patients and methods: In a two-center tertiary referral hospital retrospective analysis 4135 files of patients who had undergone transradial catheterization were screened for documented RAO. 141 patients were identified and 138 patients with complete information on the medical regimen and ultrasound examinations for a maximum of 3 months were included in the analysis, whereas 3 patients were excluded due to missing or incomplete follow-up information. Results: 3.3% of all patients that had undergone transradial catheterization featured an oligosymptomatic RAO, confirmed by color-coded duplex sonography. 21% of patients with additional anticoagulation regained full patency vs. 9% without additional anticoagulation (p = 0.07). 40% of patients with anticoagulation featured a partial or full regain of patency vs. 16% of patients without additional anticoagulation for a maximum of 3 months treatment (p = 0.006). No major bleedings were reported during the follow-up visits. Conclusions: RAO remains a rare complication of cardiac catheterization. The addition of antithrombotic therapy for 3 months appears to safely improve the partial or even full regain of radial patency in case of postinterventional RAO.

Download Full-text