scholarly journals Long-term consequences of trans-radial catheterization on the radial artery

2021 ◽  
Author(s):  
Nicholas Clarke ◽  
Geetha Jagannathan ◽  
Jennifer Lawton
Keyword(s):  
Radial Artery ◽  
Coronary Revascularization ◽  
Coronary Bypass ◽  
Coronary Intervention ◽  
Access Methods ◽  
Transradial Access ◽  
Near Occlusion ◽  
High Level ◽  
Transradial Catheterization ◽  
Thickened Intima

Background: The radial artery (RA) is often utilized for diagnostic coronary angiography and percutaneous intervention. Recent high-level evidence supports RA use in preference to saphenous vein as a conduit for coronary revascularization. Aim: To demonstrate gross and histologic changes of the RA following transradial access. Methods: We present two patients who had open RA harvest for coronary bypass surgery after transradial catheterization. Results: Examination 8 years after transradial catheterization demonstrated thickened intima and dissection, and examination 12 years following transradial catheterization with percutaneous coronary intervention demonstrated chronic dissection with thickened intima and near occlusion of the lumen. Conclusion: Transradial access via the RA, even after several years, is associated significant injury, making it unusable as a conduit for surgical coronary revascularization. A RA that has been utilized for catheterization should not be considered for coronary revascularization.

scholarly journals Comparison of Distal Transradial in the Anatomical Snuffbox versus Conventional Transradial Access for Coronary Angiography and Intervention-An Experience in 100 cases

2018 ◽  
Vol 13 (2) ◽  
pp. 40-45 ◽  
Author(s):  
Md Rasul Amin ◽  
Chayan Kumar Singha ◽  
Sajal Krisna Banerjee ◽  
Harisul Hoque ◽  
SM Ear E Mahabub ◽  
...  
Keyword(s):  
Radial Artery ◽  
Coronary Bypass ◽  
Coronary Angiogram ◽  
Cross Sectional ◽  
Radial Access ◽  
Transradial Access ◽  
Feasible Option ◽  
Procedural Success ◽  
Venous Fistula ◽  
Distal Radial Artery

Background: Distal transradial access in the anatomical snuffbox has advantages over standard proximal access in terms of patient and operator comfort levels and risk of ischemia. Radial artery preservation could be a relevant issue in patients requiring multiple radial artery procedures and coronary bypass with the use of a radial graft or construction of Arterio-Venous fistula in patient of chronic kidney disease. One relevant drawback is the challenging puncture of a small and weak artery, with a steeper learning curve.Objectives:This study sought to compare the feasibility, safety and complications of coronary angiogram and intervention betweenthe distal transradial in the anatomical snuffbox and conventional transradial access.Methods: In this cross sectional studya total of 100 patients were assigned to perform coronary angiogram or intervention through conventional transradial accessand distal transradial in the anatomical snuffboxfrom November 2017 to April 2018 in theDepartment of Cardiology, Bangabandhu Sheikh Mujib Medical University (BSMMU). We divided the total patient in two groups, with 50 patientsin each group. All of them had normal pulse in theirradial and dorsal radial artery.One group was subjected toconventional right transradial accessand another to rightdistal transradial in the anatomical snuffbox.Demographic features &complications were recorded.Results: The overall procedural success was 98% which was greater than expected in our early clinical experience for distal transradial access with 48 successful accesses out of 50 patients and for conventional radial approach it was also 98%.There was failure to access of distal radial artery in two casesthat may be due to hypoplastic/vasospastic distal radial artery and for conventional radial artery radial artery spasm was the cause. Patients of conventional radial access had more spasm, hematoma, numbness and hospital stay (p< 0.001) than distal radial access. Considering all, it may be said thatdistal transradialaccess was very much effective and safe as there was less spasm, more comfortable to the patient, no hand ischemia, hematoma, numbness, and early hospital discharge.Conclusion: Distal transradial access in the anatomical snuffbox for coronary angiogram and intervention is abetter alternative, safe and feasible option to conventional transradial access for both patients and operators.University Heart Journal Vol. 13, No. 2, July 2017; 40-45

scholarly journals Predictive Factors for Access-Site Pain Chronicity after Percutaneous Coronary Intervention via Radial Artery Access

2020 ◽  
Vol 2020 ◽  
pp. 1-8
Author(s):  
Liuda Brogiene ◽  
Giedre Baksyte ◽  
Agne Klimaite ◽  
Martynas Paliokas ◽  
Andrius Macas
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Pain Intensity ◽  
Radial Artery ◽  
Predictive Factors ◽  
Coronary Intervention ◽  
Access Site ◽  
Access Methods ◽  
Percutaneous Coronary ◽  
Pain Prevalence ◽  
Strong Opioids

Objectives. The aim of this study is to assess the prevalence and predictive factors for developing chronic access-site (A-S) pain after percutaneous coronary intervention (PCI) via radial artery access. Methods. Data of selected patients (n = 161) who underwent elective PCI were collected prospectively and analysed in 2020. Verbal analogue scale was used to evaluate pain intensity after 12, 24, and 48 h and 3 months after PCI. The univariate logistic regression analysis was used. Results. Pain prevalence decreased from 29% straight after PCI and 54% two hours later to 3.7% following 3 months after procedure. The predictors for A-S pain chronicity are diabetes (OR = 5.77 95% CI (1.07–31.08), p = 0.041 ), hematoma (OR = 6.48, 95% CI (1.06–39.66), p = 0.043 ), A-S hand neuropathy (OR = 19.93 95% CI (1.27–312.32), p = 0.033 ), A-S pain immediately after PCI (OR = 14.60 95% CI (1.63–130.27), p = 0.016 ), after 12 h (OR = 17.2 95% CI (1.60–185.27), p = 0.019 ), 24 h (OR = 48 95% CI (4.87–487), p = 0.01 ), and 48 h (OR = 23.46 95% CI (3.81–144.17), p = 0.001 ), and pain intensity immediately after procedure (OR = 3.30 95% CI (1.65–6.60), p = 0.001 ), after 2 h (OR = 2.56 95% CI (1.15–5.73), p = 0.022 ), after 12 h (OR = 3.02 95% CI (1.70–5.39), p < 0.001 ), after 24 h (OR = 3.58 95% CI (1.90–6.74), p < 0.001 ), and after 48 h (OR = 2.89 95% CI (1.72–4.87), p < 0.001 ). Pain control was performed with Ketoprofen and Ibuprofen as most used NSAIDs. 10 mg of Morphine intravenously was the choice from strong opioids if necessary. Conclusions. The prevalence of chronic A-S pain is 3.7%. Main predictive factors for the A-S pain chronicity are diabetes, hematoma, and persistent pain and pain intensity during 48 h period after PCI.

Cutaneous analgesia before transradial access for coronary intervention to prevent radial artery spasm

Perfusion ◽  
2017 ◽  
Vol 33 (2) ◽  
pp. 110-114 ◽  
Author(s):  
Ersan Tatlı ◽  
Mustafa Adem Yılmaztepe ◽  
Mustafa Gökhan Vural ◽  
Alptuğ Tokatlı ◽  
Murat Aksoy ◽  
...  
Keyword(s):  
Treatment Group ◽  
Radial Artery ◽  
Substantial Reduction ◽  
Coronary Intervention ◽  
Control Group ◽  
Access Site ◽  
Patient Discomfort ◽  
Vas Score ◽  
Coronary Interventions ◽  
Transradial Access

Aim: Transradial access (TRA) for coronary intervention is increasingly used in current clinical practice. The aim of the present study was to evaluate the hypothesis that cutaneous analgesia before TRA for coronary intervention at a puncture site 30 minutes before puncture can reduce patient discomfort and the incidence of radial artery spasm (RAS). Methods: Patients (n=104) undergoing planned coronary interventions using TRA were prospectively randomized to receive either 1 mL of 1% lidocaine subcutaneously (n=52) (control group) or subcutaneous lidocaine plus 5% lidocaine cream (n=52) cutaneously 30 minutes before puncture (treatment group). The primary endpoint was angiographically or clinically confirmed RAS. Secondary endpoints were the occurrence of patient discomfort in the forearm during the procedure and access-site crossover to the femoral artery. Patient discomfort was quantified with a visual analogue scale (VAS) score. Results: Fifty-two patients in the treatment group (60.5±9.4 years of age and 16 female) and 52 patients in the control group (60.4±9.7 years of age and 16 female) were included in the final analysis. Radial artery spasm occurrence decreased in the treatment group compared to the control group (26.9% vs 9.6%; p=0.04) accompanied by a VAS score of 3.7±1.8 in the treatment group and 4.9±2.0 in the control group; p=0.02. The access site crossover rate did not differ between the groups (7.6% vs 21.1%; p=0.09). Conclusion: Cutaneous analgesia before TRA for coronary interventions is associated with a substantial reduction in the RAS and the procedure-related level of patient discomfort.

scholarly journals Feasibility and Safety of Distal Radial Artery Access in Anatomical Snuffbox for Coronary Angiography and Coronary Intervention

2020 ◽  
Vol 18 (2) ◽  
pp. 259-262
Author(s):  
Arun Maskey ◽  
Birat Krishna Timalsena ◽  
Sheikh Aslam ◽  
Rabindra Pandey ◽  
Madhu Roka ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Coronary Angiography ◽  
Radial Artery ◽  
Vascular Access ◽  
Coronary Intervention ◽  
Pain Rating ◽  
Coronary Interventions ◽  
Transradial Access ◽  
Percutaneous Coronary ◽  
Distal Radial Artery

Background: There is limited data on feasibility and safety of coronary interventions performed using radial artery at anatomical snuffbox as vascular access point in South Asian region. Our study attempts to evaluate the feasibility and safety of coronary angiography and percutaneous coronary intervention using transradial access at anatomical snuffbox.Methods: Transradial access at anatomical snuffbox was attempted in 128 consecutive patients, who were planned for coronary angiography and/or percutaneous coronary intervention. Success in vascular access, completion of planned procedure and complications encountered, including patency of radial artery after the procedure, were investigated. Results: A total of 128 patients (76 males [59.4%]; 52 females [40.6%]) between 44-78 years of age (mean age, 59.0 +/- 10.2 years) were included in the study. Distal radial artery puncture and sheath placement was successful in all patients however planned procedure was completed in 126 (98.4%) patients. Total 90 coronary angiographies and 36 percutaneous coronary interventions were performed of which five were primary percutaneous coronary intervention. We encountered brachial artery spasm among two patient (1.5%) and significant pain and swelling among three patients (2.3%). No bleeding complication, numbness or parasthesia were observed on follow-up. Patients had average pain rating of 2.4+/- 1.1 in visual analogue pain rating scale. There were no instances of radial artery occlusion after the procedure.Conclusions: Distal radial artery, at anatomical snuffbox, is a safe and feasible alternative vascular access site for coronary angiography and percutaneous coronary intervention. Keywords: Cardiac catheter; coronary angiography; feasibility studies; percutaneous coronary intervention; radial artery; vascular access device

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.

Transradial Access for Non-Coronary Intervention: Initial Experience of Ramathibodi Hospital

2021 ◽  
Vol 104 (9) ◽  
pp. 1415-1420
Keyword(s):  
Success Rate ◽  
Radial Artery ◽  
Coronary Intervention ◽  
Initial Experience ◽  
Access Site ◽  
Palmar Arch ◽  
Promising Alternative ◽  
Technical Success Rate ◽  
Access Site Complication ◽  
Transradial Access

Objective: To describe initial experience of transradial access (TRA) for non-coronary intervention performed at body interventional radiology unit. Materials and Methods: A retrospective descriptive study was performed and included 31 cases from 27 patients that underwent TRA in the present study’s unit between May 2018 and January 2019. All cases were pre-operatively evaluated for radial artery size by ultrasound (US) and verified palmar arch patency using Barbeau test. To proceed to TRA, the radial artery diameter must be at least 1.8 mm and the Barbeau test must not be classified in type D. The primary endpoint was success rate. Secondary endpoints were patency of radial artery and other access site complication after TRA. Results: The technical success rate was 100% without crossover to transfemoral access (TFA). Asymptomatic radial artery occlusion (RAO) was observed in four cases (12.9%) using US at 24-hour after the procedure. According to statistical analysis, none of the present studied parameters showed statistically significant association with the RAO. The other access site complication detected was pseudoaneurysm, which was found in two cases. Conclusion: TRA is a promising alternative access for non-coronary intervention. Vascular access site complications are rarely clinically significant but nevertheless still a concern. Keywords: Transradial access; Non-coronary intervention; Complication; Radial artery; Patency

Abstract 16287: Effect of Transradial Catheterization on Patency Rates of Radial Arteries Used as a Conduit for Coronary Bypass

Circulation ◽  
2015 ◽  
Vol 132 (suppl_3) ◽  
Author(s):  
Mohammed Ruzieh ◽  
Ankush Moza ◽  
Pranav Diwan ◽  
Bhavana S Bangalore ◽  
Thomas Schwann ◽  
...  
Keyword(s):  
Radial Artery ◽  
Statistical Significance ◽  
Coronary Bypass ◽  
Graft Patency ◽  
Artery Occlusion ◽  
P Value ◽  
Graft Occlusion ◽  
Radial Artery Graft ◽  
Artery Graft ◽  
Transradial Catheterization

Title: Effect of transradial catheterization on patency rates of radial arteries used as a conduit for coronary bypass. Objective: To assess the difference in radial artery graft patency between patients who had the same radial artery used for angiography prior to bypass compared with those who did not. At present there are numerous studies looking at radial artery occlusion in situ after catheterization however very few studies looking at patency of the radial artery when used as a graft for CABG. Methods: A retrospective review was performed of all patients who underwent CABG at our institution in that past 15 years utilizing a radial artery graft (n= 570). Those who had subsequent imaging of the graft to evaluate patency by an angiogram or CT scan at any time were included for the study. 155 radial grafts were analyzed. The primary end point was evidence of occlusion at any point in follow up. Group A consisted of grafts in which the radial artery used for CABG had been utilized for angiography prior to CABG (n= 23). Group B consisted of grafts in which angiography was done via the femoral or contralateral radial approach (n= 132). Chi-square test was utilized to compare graft occlusion in these two groups. Statistical analyses was done using SPSS software. Results: The demographic characteristics of the patients in the two groups were similar. Occlusion of the radial artery graft was found to be more common in the group utilizing the same radial artery for angiography prior to CABG. The percentage of graft occlusion was 39 % (n= 9) in this group compared to 20 % in controls (n= 27). This difference showed a trend towards statistical significance with a p value of 0.05 Conclusion: Radial artery graft patency appears to be adversely affected by its utilization for angiography prior to CABG. Other patient, procedural and management dependent confounding factors may also affect graft patency and should be investigated in larger scale or randomized studies.

scholarly journals Surgical versus percutaneous multivessel coronary revascularization in patients with chronic kidney disease

2019 ◽  
Vol 57 (5) ◽  
pp. 994-1000
Author(s):  
Arman Kilic ◽  
Ibrahim Sultan ◽  
Thomas G Gleason ◽  
Yisi Wang ◽  
Conrad Smith ◽  
...  
Keyword(s):  
Myocardial Infarction ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Risk Adjustment ◽  
Cox Regression ◽  
Coronary Revascularization ◽  
Coronary Bypass ◽  
Coronary Intervention ◽  
Repeat Revascularization ◽  
Percutaneous Coronary

Abstract OBJECTIVES This study compared contemporary outcomes following surgical versus percutaneous coronary revascularization for multivessel coronary artery disease (MVCAD) in patients with chronic kidney disease. METHODS Patients with MVCAD and a reduced glomerular filtration rate (&lt;60 ml/min) undergoing coronary bypass surgery (CABG) or percutaneous coronary intervention (PCI) at a single institution between 2010 and 2017 were included. The primary outcome was major adverse cardiac and cerebrovascular events (MACCE) defined as a composite outcome of death, stroke, myocardial infarction or repeat revascularization. Multivariable Cox regression models were used for risk-adjustment and propensity matching was also performed. RESULTS A total of 1853 patients were included in the study (1269 CABG, 584 PCI). CABG was associated with greater 5-year freedom from MACCE (70.1% vs 47.3%, P &lt; 0.0001), a finding that persisted after risk-adjustment. The rates of early and late mortality and readmission were also lower with CABG as were individual rates of myocardial infarction and repeat revascularization. A propensity-matched analysis generated 704 well-matched patients (352 in each arm) with similar results, including greater 5-year freedom from MACCE (72.8% vs 45.8%, P &lt; 0.0001), improved 5-year survival (73.9% vs 52.3%, P &lt; 0.0001), lower readmission (cause-specific hazard ratio 0.68, 95% confidence interval 0.58–0.80; P &lt; 0.0001), lower individual rates of myocardial infarction (2.6% vs 9.7%, P &lt; 0.0001) and repeat revascularization (1.1% vs 7.4%, P &lt; 0.0001). CONCLUSIONS CABG is associated with a lower MACCE rate than that of PCI in patients with MVCAD and chronic kidney disease. Multidisciplinary discussions regarding the optimal revascularization strategy are important in MVCAD, particularly in more complex scenarios such as chronic kidney disease.

scholarly journals Coronary catheterization via distal transradial access in patient with superficial radial artery: a case report

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Yuan Fu ◽  
Lefeng Wang ◽  
Zhiyong Zhang ◽  
Kun Xia ◽  
Li Xu
Keyword(s):  
Radial Artery ◽  
Color Doppler ◽  
Anatomical Variation ◽  
Coronary Intervention ◽  
Coronary Catheterization ◽  
Transradial Access ◽  
Novel Approach ◽  
Percutaneous Coronary ◽  
Anatomic Variants ◽  
To Receive

Abstract Background The routine radial artery (RA) puncture may fail when anatomical variation of the RA is encountered. Superficial radial artery (SRA) is one of the anatomic variants of the RA, with the incidence of about 1 to 1.5%. Recently, distal transradial access (dTRA) has emerged as a novel approach for coronary catheterization (CC), but performing CC through dTRA in patient with SRA has never been reported. Case presentation A 57-year-old male was admitted to hospital due to intermittent chest pain for 4 days. He was diagnosed with unstable angina pectoris and planned to receive coronary angiography (CAG). Before the operation, the existence and course of SRA were confirmed by palpation and ultrasonography with color Doppler. We marked the puncture site under the guidance of ultrasonography and successfully performed CC through the dTRA during patient’s hospitalization. Conclusions As far as we know, this is the first report that presents a case of SRA and percutaneous coronary intervention (PCI) treatment in which was successfully performed through dTRA. It is safe and feasible to perform CC via dTRA in case of SRA, and dTRA seems to be the preferred access.

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