scholarly journals Randomized clinical study on radial artery compression time after elective coronary angiography

2018 ◽  
Vol 26 (0) ◽  
Author(s):  
Maria Aparecida de Carvalho Campos ◽  
Claudia Maria Rodrigues Alves ◽  
Miriam Harumi Tsunemi ◽  
Maria Angélica Sorgini Peterlini ◽  
Ariane Ferreira Machado Avelar
Keyword(s):  
Clinical Trials ◽  
Clinical Study ◽  
Coronary Angiography ◽  
Radial Artery ◽  
Vascular Complications ◽  
Study Groups ◽  
Randomized Clinical Study ◽  
Compression Time ◽  
Vascular Ultrasonography

Objective to compare two compression times of the radial artery after coronary angiography with customized compressive dressing regarding the occurrence of hemostasis and vascular complications. Method a randomized clinical study was carried out in patients undergoing elective transradial coronary angiography in two study groups: (G30), whose compressive dressing was maintained for 30 minutes, and (G60), whose compressive dressing was maintained for 60 minutes, both until the first evaluation of hemostasis. Variables related to patients, procedure, occurrence of hemostasis, and vascular complications were analyzed. Patency of the radial artery was assessed with Doppler vascular ultrasonography, immediately after removing the compressive dressing and 30 days after the procedure. Results the sample consisted of 152 patients in G30 and 151 in G60. Hemostasis was evidenced in the first evaluation in 76.3% of G30 patients and 84.2% of G60 patients (p = 0.063). There were 91 immediate complications, being 53 hematomas and 38 occlusions of the radial artery. We identified 18 late occlusions, 7 (5.5%) in G30 and 11 (8.2%) in G60. Conclusion the different compression times of the radial artery after coronary angiography did not significantly influence the occurrence of hemostasis and vascular complications. Brazilian Registry of Clinical Trials (Rebec): RBR-7VJYMJ.

Comparison of Clinical Value between Right Distal Radial Artery Access and Right Radial Artery Access in Patients Undergoing Coronary Angiography or Percutaneous Coronary Intervention

2020 ◽  
Author(s):  
Jianhua Fan
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Angiography ◽  
Radial Artery ◽  
Coronary Intervention ◽  
Access Time ◽  
Arterial Access ◽  
Compression Time ◽  
Percutaneous Coronary ◽  
The Right ◽  
Distal Radial Artery

Objective: To compare the feasibility and safety between right distal radial artery access and right radial artery accessin patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI).Methods: On the basis of arterial access, 113 patients who underwent CAG or PCI in Kunshan Hospital of TraditionalChinese Medicine between January and October 2018 were divided into two groups: a right distal radial artery group (52 patients) and a right radial artery group (61 patients). We collected general information, the number of puncture attempts, access times, postoperative compression time, and complications.Results: The general characteristics, rate of successful radial artery puncture, and rate of successful catheter placement inthe two groups were not different. The right radial artery group had fewer puncture attempts (1.26 ± 0.44 times vs. 2.19 ± 0.53times, P = 0.001) and a shorter access time (3.23 ± 0.86 min vs. 4.77 ± 1.49 min, P = 0.001) than the right distal radial arterygroup. However, the postoperative compression time in the right distal radial artery group was shorter (3.44 ± 0.9 h vs.7.16 ± 1.21 h, P = 0.001). Two cases of bleeding, four cases of hematoma, and one case of artery occlusion in the right radialartery group and one case of hematoma in the right distal artery group occurred before discharge. The rate of total complicationsin the right distal radial artery group was lower than in the right radial artery group (1.93% vs. 11.48%, P = 0.048).Conclusion: CAG or PCI through the right distal radial artery is feasible and safe.

scholarly journals Distal Radial Artery Access for Coronary and Peripheral Procedures: A Multicenter Experience

2021 ◽  
Vol 10 (24) ◽  
pp. 5974
Author(s):  
Alexandru Achim ◽  
Kornél Kákonyi ◽  
Zoltán Jambrik ◽  
Ferenc Nagy ◽  
Julia Tóth ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Success Rate ◽  
Radial Artery ◽  
Vascular Complications ◽  
Coronary Intervention ◽  
Learning Curves ◽  
Bleeding Complications ◽  
Entry Site ◽  
Catheterization Laboratory ◽  
Distal Radial Artery

Introduction: Distal radial access (dRA) has recently gained global popularity as an alternative access route for vascular procedures. Among the benefits of dRA are the low risk of entry site bleeding complications, the low rate of radial artery occlusion, and improved patient and operator comfort. The aim of this large multicenter registry was to demonstrate the feasibility and safety of dRA in a wide variety of routine procedures in the catheterization laboratory, ranging from coronary angiography and percutaneous coronary intervention to peripheral procedures. Methods: The study comprised 1240 patients who underwent coronary angiography, PCI or noncoronary procedures through dRA in two Hungarian centers from January 2019 to April 2021. Baseline patient characteristics, number and duration of arterial punctures, procedural success rate, crossover rate, postoperative compression time, complications, hospitalization duration, and different learning curves were analyzed. Results: The average patient age was 66.4 years, with 66.8% of patients being male. The majority of patients (74.04%) underwent a coronary procedure, whereas 25.96% were involved in noncoronary interventions. dRA was successfully punctured in 97% of all patients, in all cases with ultrasound guidance. Access site crossover was performed in 2.58% of the patients, mainly via the contralateral dRA. After experiencing 150 cases, the dRA success rate plateaued at >96%. Our dedicated dRA step-by step protocol resulted in high open radial artery (RA) rates: distal and proximal RA pulses were palpable in 99.68% of all patients at hospital discharge. The rate of minor vascular complications was low (1.5%). A threshold of 50 cases was sufficient for already skilled radial operators to establish a reliable procedural method of dRA access. Conclusion: The implementation of distal radial artery access in the everyday routine of a catheterization laboratory for coronary and noncoronary interventions is feasible and safe with an acceptable learning curve.

scholarly journals Radial pseudoaneurysm following diagnostic coronary angiography

2015 ◽  
Vol 10 (3) ◽  
pp. 48-50
Author(s):  
Shankar Laudari ◽  
Sachin Dhungel ◽  
Laxman Dubey ◽  
Guru Prasad ◽  
R Bhattacharya ◽  
...  
Keyword(s):  
Coronary Angiography ◽  
Radial Artery ◽  
Femoral Artery ◽  
Rare Complication ◽  
Vascular Complications ◽  
Medical Sciences ◽  
Artery Pseudoaneurysm ◽  
Early Ambulation ◽  
Coronary Catheterization ◽  
Diagnostic Coronary Angiography

The radial artery access has gained popularity as a method of diagnostic coronary catheterization compared to femoral artery puncture in terms of vascular complications and early ambulation. However, very rare complication like radial artery pseudoaneurysm may occur following cardiac catheterization which may give rise to serious consequences. Here, we report a patient with radial pseudoaneurysm following diagnostic coronary angiography. Adequate and correct methodology of compression of radial artery following puncture for maintaining hemostasis is the key to prevention.DOI: http://dx.doi.org/10.3126/jcmsn.v10i3.12776 Journal of College of Medical Sciences-Nepal, 2014, Vol-10, No-3, 48-50

scholarly journals Recanalization of the occluded radial artery via distal transradial access in the anatomic snuffbox

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Feng Li ◽  
Gan-Wei Shi ◽  
Bi-Feng Zhang ◽  
Xiao-Long Yu ◽  
Hao-Min Huang ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Angiography ◽  
Radial Artery ◽  
Coronary Intervention ◽  
Artery Occlusion ◽  
Transradial Access ◽  
Vascular Ultrasonography ◽  
Percutaneous Coronary ◽  
Radial Artery Occlusion ◽  
The Right

Abstract Background Radial artery occlusion is a common complication after coronary angiography and percutaneous coronary intervention via the transradial access. In recent years, coronary angiography and percutaneous coronary intervention via the distal transradial access has gradually emerged, but recanalization of the occluded radial artery through the distal transradial access has rarely been reported. Case presentation A 67-year-old female with arterial hypertension and diabetes mellitus was admitted to the hospital due to chest pain for three hours. She was diagnosed with acute myocardial infarction. After admission, the patient successfully underwent emergency coronary angiography and percutaneous coronary intervention through the right transradial access. Radial artery occlusion was found after the operation, and recanalization was successfully performed through the right distal transradial access before discharge. Immediately after the operation and one month later, vascular ultrasonography showed that the antegrade flow was normal. Conclusions This report presents a case of radial artery occlusion after emergency coronary angiography and percutaneous coronary intervention in which recanalization was successfully performed through the right distal transradial access. This case demonstrates that recanalization of a radial artery occlusion via the distal transradial access is safe and feasible.

P3581Periinterventional cocoa flavanol supplementation prevents functional and structural damage to the arterial wall after transradial catheter intervention

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
M Grone ◽  
M Ophoff ◽  
C Heiss ◽  
M Kelm ◽  
R Sansone
Keyword(s):  
Coronary Angiography ◽  
Endothelial Function ◽  
Radial Artery ◽  
Intimal Hyperplasia ◽  
Vascular Remodeling ◽  
Structural Damage ◽  
Structural Changes ◽  
Vascular Complications ◽  
Placebo Control ◽  
Circulating Levels

Abstract Background The transradial approach is commonly preferred over the femoral approach for coronary angiography to reduce vascular complications like bleeding, aneurysm formation and all-cause mortality ensuring early ambulation after coronary procedures. However, there is growing evidence that damage to the radial artery endothelium elicits intimal hyperplasia, vascular remodeling and might ultimately lead to total vessel occlusion. Objective Our study aimed to investigate the effects of dietary flavanol intervention on (a) early endothelial functional recovery and (b) late structural changes i.e. intimal hyperplasia after mechanical vascular wall injury in the human forearm model during coronary angiography. Methods Radial artery flow-mediated vasodilation (RA-FMD), local stiffness (fractional diameter change, Fdc), intima-media thickness (IMT), luminal and external arterial diameter at the site of intervention and the contralateral control artery were measured in 38 male patients (19 flavanol intervention, 19 placebo control) undergoing transradial coronary angiography (TCA) at baseline, after 7 days of 450mg flavanol supplementation BID, directly after TCA and 6 months after TCA. Circulating levels of endothelial microparticle (EMP) subpopulations CD31+/41-, CD62e+and CD144+were analyzed simultaneously as a surrogate for endothelial functional integrity and activation. Results One week of flavanol supplementation, not placebo, significantly increased RA-FMD (8.88±2.03% vs. 11.17±2.89%, p<0.01 in flavanol and 8.64±1.87% vs. 8.32±1.63%, p=n.s. in placebo). RA-FMD significantly decreased in the intervention artery directly after TCA, which was partly mitigated by flavanol supplementation (delta to baseline: −2.61±0.82% in flavanol vs. −4.91±0.63% in placebo, p=0.034). TCA induced significant intimal hyperplasia in the radial artery (0.36±0.02mm vs. 0.44±0.04mm, p<0.01) in placebo, but not in the flavanol group (0.36±0.02mm vs. 0.37±0.02mm, p=n.s.) after 6 month. One week of flavanol supplementation increased Fdc (1.94±0.99 vs. 3.07±1.31, p<0.01). No changes occurred in the placebo group (1.99±1.29 vs. 1.96±1.17, p=n.s.). On the contralateral arm, the decrease in RA-FMD was blunted by flavanols (delta to baseline: +0.42±1.05% in flavanol vs. −0.61±1.55% in placebo) along with decreased circulating levels of EMPs. Conclusions TCA impairs endothelial function (RA-FMD), vascular physicomechanics (Fdc) and induces intimal hyperplasia (IMT). Periinterventional flavanol supplementation blunts the acute decreases in endothelial function and physicomechanics and prevents chronic negative vascular remodeling.

scholarly journals Comparison of Clinical Value between Right Distal Radial Artery Access and Right Radial Artery Access in Patients Undergoing Coronary Angiography or Percutaneous Coronary Intervention

2020 ◽  
Vol 5 (2) ◽  
pp. 103-107
Author(s):  
Wen Pan ◽  
Haixiang Xu ◽  
Qingjun Liu ◽  
Jianhua Fan
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Angiography ◽  
Radial Artery ◽  
Coronary Intervention ◽  
Access Time ◽  
Arterial Access ◽  
Compression Time ◽  
Percutaneous Coronary ◽  
The Right ◽  
Distal Radial Artery

Objective: To compare the feasibility and safety between right distal radial artery access and right radial artery access in patients undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI).Methods: On the basis of arterial access, 113 patients who underwent CAG or PCI in Kunshan Hospital of Traditional Chinese Medicine between January and October 2018 were divided into two groups: a right distal radial artery group (52 patients) and a right radial artery group (61 patients). We collected general information, the number of puncture attempts, access times, postoperative compression time, and complications.Results: The general characteristics, rate of successful radial artery puncture, and rate of successful catheter placement in the two groups were not different. The right radial artery group had fewer puncture attempts (1.26±0.44 times vs. 2.19±0.53 times, P=0.001) and a shorter access time (3.23±0.86 min vs. 4.77±1.49 min, P=0.001) than the right distal radial artery group. However, the postoperative compression time in the right distal radial artery group was shorter (3.44±0.9 h vs. 7.16±1.21 h, P=0.001). Two cases of bleeding, four cases of hematoma, and one case of artery occlusion in the right radial artery group and one case of hematoma in the right distal artery group occurred before discharge. The rate of total complications in the right distal radial artery group was lower than in the right radial artery group (1.93% vs. 11.48%, P=0.048).Conclusion: CAG or PCI through the right distal radial artery is feasible and safe.

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