Adverse local reactions to the use of hydrophilic sheaths for radial artery canulation

There have been reports of local sterile inflammatory reactions with the use of Cook hydrophilic-coated sheaths (HCS) for transradial coronary angiography/intervention. Our aim was to gauge the extent of radial artery access site complications following radial artery canulation and to compare the incidence of such complications with HCS versus non-coated sheaths in our hospital. We undertook a retrospective questionnaire-based postal study, receiving replies from 1283 patients who had transradial coronary angiography/percutaneous coronary intervention in our institution between Feb 2005 and Oct 2006. HCS had been used in 856 of these patients. Patients reported adverse local reactions at the access site in 12.9% of cases, including pain (57.2%), swelling (27.7%) and non-specific sensory abnormalities (13.2%). A total of 5.0% of patients sought medical help for their problem, mainly (78.1%) from their general practitioner. The use of a HCS compared to a non-coated sheath was associated with a significant excess of patient-reported adverse reactions (14.6% vs. 9.6%, p=0.015). A logistic regression analysis confirmed that the use of a hydrophilic sheath (OR 1.5, (1.05-2.26)) and female gender (OR 1.9, (1.4-2.8)), were independent predictors of self-reported adverse outcomes after controlling for possible confounders.