Interruption of blood flow during compression and radial artery occlusion after transradial catheterization

To analyze the possible relationship between compression after transradial catheterization and radial artery occlusion.

Radial artery occlusion is an important concern of transradial catheterization. Interruption of radial artery flow during compression might influence the rate of radial artery occlusion at follow-up.

A prospective study including 275 consecutive patients undergoing transradial catheterization was conducted. Arterial sheaths were removed immediately after procedures and conventional compressive dressings were left in place for 2 hr. The pulse oximeter signal in the index finger during ipsilateral ulnar compression was used for the assessment of radial artery flow.

Radial artery flow was absent in 174 cases (62%) immediately after entry-site compression. After 2 hr of conventional hemostasis, radial artery flow was absent in 162 cases (58%) before bandage removal. At 7-day follow-up, 12 patients (4.4%) had absent pulsations and radial artery flow was absent in 29 cases (10.5%). Patients with an occluded radial artery at follow-up had significantly smaller arterial diameters at baseline (2.23+/-0.4 mm vs. 2.40+/-0.5 mm; P=0.032) and more frequently had absent flow during hemostasis (90% vs. 54%, P<0.001). Stepwise logistic regression analysis revealed that absent flow before compressive bandages removal was the only independent predictor of radial artery occlusion at follow-up (OR=6.7; IC 95%: 1.95-22.9; P=0.002).

Flow-limiting compression is a frequent finding during conventional hemostasis after transradial catheterization. Absence of radial artery flow during compression represents a strong predictor of radial artery occlusion.