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Procedural outcomes of repeated transradial coronary procedure
Byung-Su Yoo1, Seung-Hwan Lee, Ji-Yean Ko
1Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea. yoonj@wonju.yonsei.ac.kr
Insights
Repeated transradial procedures are feasible, demonstrating high success rates and minimal complications. While radial artery diameter shows a slight decrease over time, it does not impede subsequent interventions, though occlusion risk increases slightly.
Area of Science:
- Cardiovascular Interventions
- Vascular Access Techniques
Background:
- Transradial access is a common approach for percutaneous coronary interventions.
- Concerns exist regarding the safety and efficacy of repeated access through the same radial artery.
Purpose of the Study:
- To evaluate changes in radial artery diameter and procedural outcomes after repeated transradial procedures.
- To assess the feasibility and safety of utilizing the same radial artery for multiple interventions.
Main Methods:
- Prospective evaluation of 117 patients undergoing repeated transradial procedures.
- Measurement of radial artery diameter pre-procedure and post-procedure (1 day and follow-up).
- Comparison of procedural times, success rates, and complication incidence between initial and repeated procedures.
Main Results:
- No significant difference in radial artery diameter immediately post-procedure (initial vs. repeated).
- A significant decrease in mean radial artery diameter was observed during follow-up after the initial procedure (P=0.01).
- Procedural success rates were similar for initial and repeated procedures, but radial artery occlusion incidence was higher in repeated procedures (2.6% vs. 0%, P=0.01).
Conclusions:
- Repeated transradial procedures through the same radial artery are feasible in most patients.
- High procedural success rates and low vascular complications are achievable.
- Increased vigilance for radial artery occlusion is warranted with repeated access.
Abstract:
We evaluated the changes in radial arterial diameter and the procedural outcomes of repeated transradial procedures through the same radial artery in 117 cases. No significant differences were found in the mean diameter of the radial artery between preprocedure and 1 day after procedure on initial and repeated procedures. However, the mean radial arterial diameter was significantly decreased from 2.63 +/- 0.35 to 2.51 +/- 0.29 mm during follow-up after the initial procedure (P = 0.01). There was no significant difference in the vascular access times of the initial and repeated procedures (2.9 +/- 3.1 vs. 3.3 +/- 3.6 min; P = 0.08), and procedural success of repeated procedure was similar to those of the initial procedure. However, the incidence of radial arterial occlusion was higher for repeated procedures (2.6% vs. 0%; P = 0.01). We conclude that the repeated use of the radial artery is feasible in most patients with a high procedural success rate and low vascular complications.