scholarly journals Radial Artery Patency after Trans-radial Cardiac Catheterization in a Bangladeshi Population

2015 ◽  
Vol 10 (2) ◽  
pp. 66-72
Author(s):  
Mashhud Zia Chowdhury ◽  
CM Shaheen Kabir ◽  
Sahela Nasrin ◽  
Hemanta I Gomes ◽  
Md Enamul Hakim ◽  
...  
Keyword(s):  
Radial Artery ◽  
Cardiac Catheterization ◽  
Resistance Index ◽  
Peak Systolic Velocity ◽  
Coronary Intervention ◽  
Artery Occlusion ◽  
Diastolic Velocity ◽  
Study Population ◽  
Bangladeshi Population

Background: Transradial cardiac catheterization (TCC) is now preferred method over trans-femoral approach globally including Bangladesh. But the incidence of radial artery occlusion (RAO) after TCC is not infrequent and it ranges from 1-18% in different studies. The aim of our study was to see the incidence of RAO after TCC in a population coming for coronary angiogram and/or coronary intervention and also to evaluate the factors responsible for RAO. Methods: The observational prospective study was performed in all consecutive patients coming for TCC. Pre and three month post-procedural modified Allen’s test, reverse Barbeau test & Duplex ultrasonography for radial artery diameter (RAD), peak systolic velocity (PSV), end-diastolic velocity (EDV) and resistance index (RI) were measured. Results: 69 patients underwent TCC. Mean age was 54 years, 67% were male, 80% hypertensive, 65% diabetic. Follow-up at third month showed one total RAO (1.45%) and mean RAD of the remaining patients was significantly reduced from 2.2+0.03 mm to 2.1+0.03 mm (p=0.001) but none had any symptom or sign of ischemic hand. PSV, EDV & RI were not significantly altered. Reduction of RAD (to <2.0 mm) were significantly higher in female (p=0.032), but no association was found in presence of diabetes or its duration, hypertension, dyslipidaemia, smoking, peripheral vascular disease. The size & number of catheters used or duration of vascular access sheath kept in the artery did not affect the reduction of RAD.Conclusion: The mean RAD of the study was smaller than other study population, but incidence of RAO is very low. RAD was significantly reduced after procedure without any clinical evidence of ischemia or alteration of flow velocity. Female sex was the only factor found to be associated with reduction of RAD in this study.University Heart Journal Vol. 10, No. 2, July 2014; 66-72

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.

Retrograde Recanalization of Occluded Radial Artery: A Single-Centre Experience and Literature Review

2022 ◽  
pp. 152660282110677
Author(s):  
Ganwei Shi ◽  
Feng Li ◽  
Liuyan Zhang ◽  
Chun Gong ◽  
Sheliang Xue ◽  
...  
Keyword(s):  
Literature Review ◽  
Success Rate ◽  
Radial Artery ◽  
Cardiac Catheterization ◽  
Case Series ◽  
Coronary Intervention ◽  
Artery Occlusion ◽  
Total Occlusion ◽  
Single Centre Experience ◽  
The Common

Purpose: Radial artery occlusion (RAO) is one of the common complications after coronary intervention via the conventional radial artery approach. The purpose of the study was to explore the safety and feasibility of retrograde recanalization of the occluded radial artery via a distal radial artery (DRA) approach. Methods: Combined with the practice of our centre and a literature review, we summarized the procedure of retrograde recanalization of RAO, success rate, and complications. Results: A total of 14 of 15 patients with 15 pieces of occluded radial arteries were successfully recanalized via the DRA in our centre. In the 15 occluded vessels, 11 vessels (73.3%) had total occlusion and 4 vessels (26.7%) had functional occlusion. Four of 15 occluded vessels were acute occlusions. Two acute RAOs were only treated with aspiration via sheath, 11 RAOs with balloon angioplasty, and 2 RAOs with both, respectively. In 6 patients, cardiac catheterization was carried out via the DRA after recanalizing the RAO. A total of 10 studies reporting the results of recanalization of RAO via the DRA were systematically retrieved in the present study. In 3 case series, the number of cases was more than 5, and the success rate of recanalization was more than 85.7%. Two studies reported complications, including dissection in one case, hematoma in 2 cases, and pain in the forearm during angioplasty. Conclusions: Recanalization of the occluded radial artery via the DRA was safe and effective. When repeat cardiac catheterization was required, recanalization of the RAO and subsequent coronary angiography or intervention through the ipsilateral radial artery approach was feasible.

scholarly journals Laser-assisted strategy for reflux abolition in a modified CHIVA approach

2015 ◽  
Vol 4 (2) ◽  
Author(s):  
Sergio Gianesini ◽  
Erica Menegatti ◽  
Michele Zuolo ◽  
Mirko Tessari ◽  
Paolo Spath ◽  
...  
Keyword(s):  
Severity Score ◽  
Resistance Index ◽  
Peak Systolic Velocity ◽  
Clinical Severity ◽  
Chronic Venous Disease ◽  
Venous Disease ◽  
Clinical Severity Score ◽  
Diastolic Velocity ◽  
Venous Clinical Severity Score

The aim of this study was to assess feasibility and efficacy of an endovenous laser (EL) assisted saphenous-sparing strategy in chronic venous disease (CVD). Fourteen CVD patients (C2,3,4s Ep As Pr1,2,3) underwent a saphenofemoral junction (SFJ) treatment by EL just from below the superficial epigastric vein downward for a limited tract, together with a flush ligation of the incompetent tributaries of the great saphenous vein (GSV) along the leg. The following GSV parameters were assessed 15 cm below the SFJ: reflux time, caliber, peak systolic velocity (PSV), end diastolic velocity (EDV), resistance index (RI). Venous clinical severity score and the Clinical, Etiological, Anatomical, and Pathophysio logical (CEAP) classification clinical classes were assessed. At 1 year follow up 3 cases were considered failures because of a GSV thrombosis, even if they presented a GSV recanalization with a laminar flow within at the 2 years follow-up. Eleven procedures succeeded because neither minor nor major peri-procedural complications were reported, apart 2 cases of self-healing bruising. In these last 11 cases the procedure led to a GSV reflux suppression (from 3.1±0.4 s to a retrograde laminar draining flow), to a GSV caliber reduction (from 9.4±0.5 to 3.1±0.2 cm, P&lt;0.001), to a PSV reduction (from 50.2±4.6 to 18.4±3.5 cm/s, P&lt;0.001), to a RI reduction (from 0.9±0.2 to 0.51±0.2, P&lt;0.005) and to an oscillatory flow suppression (EDV from -8.9±1.6 to 6.2±2.3 cm/s, P&lt;0.001). Both CEAP and venous clinical severity score improved from 3 to 1 (P&lt;0.001) and from 7±2 to 2±1 (P&lt;0.05), respectively. The GSV flow reappeared below the shrunk tract draining into the re-entry perforator. Sapheno-femoral reflux suppression can be obtained by just a GSV segmental closure. An almost 80% of success rate of the present investigation paves the way for an even wider diffusion of endovenous techniques, moreover erasing the surgical requirements for those who would like to perform a saphenoussparing strategy. In this way new devices could be used inside equally innovative strategies.

scholarly journals Radial artery occlusion after cardiac catheterization and impact of medical treatment

VASA ◽  
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.

scholarly journals Post-exercise pulsatility index indicates treatment effects in peripheral arterial occlusive disease (PAOD)

2021 ◽  
Author(s):  
Andrej Udelnow ◽  
Maria Hawemann ◽  
Ivo Buschmann ◽  
Frank Meyer ◽  
Zuhir Halloul
Keyword(s):  
Repeated Measures ◽  
Pulsatility Index ◽  
Treatment Effects ◽  
Resistance Index ◽  
Peak Systolic Velocity ◽  
Arterial Tree ◽  
Post Exercise ◽  
Diastolic Velocity ◽  
Before And After ◽  
Healthy Persons

Summary Background Hypothesis: Post-exercise measurements better discriminate PAOD-patients from healthy persons and they more sensitively detect hemodynamic improvements after treatment procedures than resting measurements. Methods A total of 19 healthy volunteers and 23 consecutive PAOD-patients underwent measurements of peak systolic velocity (PSV), end-diastolic velocity (EDV), minimal diastolic velocity (MDV), time-averaged maximum velocities (TAMAX), resistance index (RI) and pulsatility index (PI) before and after a standard exercise test (at 1, 2, 3, 4 and 5 min) before and after treatment (incl. epidemiological data, PAOD risk factors and comorbidities). Results In resting values, healthy persons and PAOD-patients did not differ significantly in any of the hemodynamic parameters. PSV increased after treatment in PAOD-patients by 5 cm/s (paired t‑test, p: 0.025); however, when the amplitude of autoregulatory changes related to the resting values were calculated, PAOD-patients showed clearly less hemodynamic changes after exercise than healthy persons (p: 0.04; 0.002; <0.001 for PSV, TAMAX and PI, resp.). The time course after exercise was compared by repeated measures of ANOVA. Healthy persons differed significantly in PI, RI and PSV from PAOD patients before and after treatment (p<0.001 each). The PAOD-patients revealed a significantly improved PI after treatment (p: 0.042). The only factor contributing significantly to PI independently from grouping was direct arterial vascularization as compared to discontinuous effects by an obstructed arterial tree. Conclusion Healthy persons cannot be well differentiated from PAOD-patients solely by hemodynamics at rest but by characteristic changes after standard exercise. Treatment effects are reflected by higher PI-values after exercise.

Low-molecular-weight-heparin in radial artery occlusion treatment: the LOW-RAO randomized study

2021 ◽  
Author(s):  
Matthaios Didagelos ◽  
Areti Pagiantza ◽  
Thomas Zegkos ◽  
Christos Papanastasiou ◽  
Konstantina Zarra ◽  
...  
Keyword(s):  
Molecular Weight ◽  
Radial Artery ◽  
Low Molecular Weight Heparin ◽  
Controlled Trial ◽  
Randomized Study ◽  
Coronary Intervention ◽  
Artery Occlusion ◽  
Low Molecular Weight ◽  
Open Label ◽  
Radial Artery Occlusion

Radial artery occlusion (RAO) is the commonest complication of transradial catheterization. There is no evidence-based therapy, in the frame of a randomized control study, for the treatment of RAO. The purpose of the LOW-RAO study is to question the hypothesis if low-molecular-weight heparin is effective in the treatment of RAO after transradial coronary catheterization (both angiography and percutaneous coronary intervention). It is a prospective, open label, randomized controlled trial that will randomize 60 patients with RAO, irrespective of symptoms, into two groups, one receiving anticoagulation with low-molecular-weight heparin and the other receiving no treatment. The primary end point is improvement in radial artery patency rate at 4 weeks after the procedure. Trial registration number: NCT04196309 (ClinicalTrials.gov)

scholarly journals Malapposed Struts with Cre8, Biomatrix, and Xience Stents Assessed with OCT Immediately after Implantation and at 6-Month Follow-Up: Can the Different Biomechanical Characteristics of the Three Stents Impact on Struts Malapposition?

2021 ◽  
Vol 2021 ◽  
pp. 1-9
Author(s):  
Cristina Giglioli ◽  
Emanuele Cecchi ◽  
Chiara Formentini ◽  
Marco Chiostri ◽  
Niccolò Marchionni ◽  
...  
Keyword(s):  
Cross Sections ◽  
Coronary Intervention ◽  
Clinical Effects ◽  
Index Procedure ◽  
Percutaneous Coronary ◽  
Single Operator ◽  
Drug Eluting ◽  
Study Population ◽  
To Receive

Background. Although the clinical effects of stent malapposition remain controversial, several analyses of stent registries consistently have found that malapposed struts were frequently identified in patients who experienced stent thrombosis. In this study, which is a subanalysis of the previously published CREBX-OCT study, we compared optical coherence tomography (OCT) analysis at the index percutaneous coronary intervention (PCI) and at six-month follow-up in 37 patients randomly assigned to receive, by a single operator, three different second-generation drug-eluting stents (Cre8, Biomatrix, and Xience) aiming to clarify if the malapposition observed at six-month follow-up was persistent or late-acquired. Moreover, we investigated if there were some differences in the behavior of the three different kinds of stents in relation to the struts malapposition. Material and Methods. We analyzed 614 and 599 cross sections and 5514 and 5377 struts at the index PCI and at six-month follow-up, respectively. The qualitative analysis of the plaque composition among the three groups did not show significant differences. Results. The lumen area did not significantly change from the index procedure to the six-month follow-up in the three groups; on the contrary, the number of malapposed struts increased significantly in the Cre8 and Biomatrix groups but not in the Xience group: 0.58 ± 1.51 and 3.29 ± 5.33 ( p < 0.023 ) in the Cre8 group, 0.55 ± 1.81 and 1.73 ± 2.28 ( p < 0.024 ) in the Biomatrix group, and 0.55 ± 1.5 and 0.25 ± 0.87 ( p < 0.166 ) in the Xience group, respectively. Conclusions. Therefore, the malapposition observed at six-month follow-up in our study population could be mainly considered as acquired and attributable to biomechanical reasons due to the structural differences among the three stents. This trial is registered with Clinical Trials.gov Identifier: NCT02850497.

Abstract 111: Assessing Statin Therapy and Lipid Profile Goals 6 Months After Percutaneous Coronary Intervention at a Veterans Hospital

2013 ◽  
Vol 6 (suppl_1) ◽  
Author(s):  
Dmitry Blumenkrants ◽  
Saifullah M Siddiqui ◽  
Karthik Challa ◽  
Amit Ladani ◽  
Adhir Shroff
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Statin Therapy ◽  
Coronary Intervention ◽  
Lipid Lowering ◽  
Lipid Lowering Therapy ◽  
Percutaneous Coronary ◽  
Core Measure ◽  
Study Population ◽  
Artery Disease

Background: Patients undergoing percutaneous coronary intervention (PCI) represent a high-risk cohort for cardiovascular events. Lipid lowering therapy is an established core measure of secondary prevention in coronary artery disease management. The NCEP-ATPIII advises a minimum LDL level < 100 mg/dL in patients with coronary heart disease (CHD). However, further research suggests that an LDL < 70 is more desirable in this population to further reduce adverse CHD endpoints. Methods: We conducted a retrospective, observational study on all patients undergoing PCI at an urban Veterans Hospital from September 2004 to December 2011. Statin use and lipid profiles at 6 months post-PCI were compared to pre-PCI values. Results: A total of 1052 unique patients had PCI during the study period. Approximately 70% of patients were on statins at baseline, which improved to 88% at 6 months post-PCI (p < 0.0001). LDL levels improved significantly when compared to pre-PCI levels, from a mean of 97.2 to 85.1 (p < 0.0001). With regards to NCEP-ATPIII guidelines, the proportion of the study population that met minimum LDL goals (<100) post-PCI increased from 59% to 76% (p < 0.0001). The percentage of patients meeting ideal goals for LDL (<70) increased from 23% to 33% (p < 0.0001). Conclusion: In patients who have undergone PCI, there was significant improvement in LDL levels. At six months, there was an increase in usage of statin therapy. Furthermore there was a statistically significant increase in adherence to NCEP-ATIII guidelines at both the minimum and ideal LDL levels on follow-up after PCI.

P6523Radial artery occlusion: predictors, methods for reducing the frequency of complications-a single center study

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
D Ognerubov ◽  
A Tereshchenko ◽  
E Merkulov ◽  
S Provatorov ◽  
G Arutyunyan ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Coronary Angiography ◽  
Radial Artery ◽  
Stable Coronary Artery Disease ◽  
Ulnar Artery ◽  
Coronary Intervention ◽  
Artery Occlusion ◽  
Careful Examination ◽  
Radial Access ◽  
Short Time

Abstract Radial access has great advantages in terms of the frequency of complications, but it has one specific complication - radial artery occlusion (RAO). This complication often does not manifest itself in any way; however, it limits the use of access for the future interventions. Aim To compare methods of short and traditional hemostasis and to identify the main predictors of RAO after radial access. Materials and methods During the period from 2012 to 2018, 2000 patients were included in the study, which consisted of two parts: prospective - 1000 patients who underwent coronary angiography and percutaneous coronary intervention (PCI) with stable coronary artery disease, and retrospective part of the study, which included 1000 patients admitted for PCI from other clinics. In a prospective study, patients were divided into two groups: after coronary angiography and PCI, respectively (n=500 in the coronary angiography group and n=500 in the PCI group), and then randomized. Hemostatic bandages in the first group of patients (n=250) were removed after 12–24 hours, in the second group (n=250) - after 4±1 hours. When the occlusion of the radial artery was detected, all patients underwent an hour-long compression of the ipsilateral ulnar artery to recanalize acute RAO. Results The frequency of RAO in the retrospective part of the study was 21.8%. The frequency of RAO in the prospective part of the study was 10.2% with a traditional time hemostasis and 1.4% with a short-time compression (P<0.001). Predictors of the RAO are illustrated in table 1. Predictors of bleeding were PCI (OR 0.12, 95% CI 0.01–0.67, P=0.05) and weight (OR 1.09, 95% CI 1.02–1.18, P=0.01). Table 1. Predictors of RAO Variables Odds ratio 95% Confidential interval Significance, P Traditional-time hemostasis 8.78 4.2–21.5 <0.001 Diabetes mellitus+smoking 18.1 12.7–26.7 <0.001 Diabetes mellitus 0.45 0.25–0.83 0.009 Body mass index 0.95 0.91–0.99 0.02 Male 1.75 1.01–3.18 0.05 Protein C 0,86 0,75–0,96 0,01 Conclusion Careful examination of the patient for detecting RAO before and after interventions is essential. Short hemostasis with compression of the ipsilateral ulnar artery reduce the frequency of RAO. For short-time hemostasis, special attention should be paid to patients after PCI and with low BMI, as far as these factors are associated with a greater risk of bleeding after removal of the compression bandage.

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