Related Experiment Video
Updated: Jun 20, 2026
Transradial Access Chemoembolization for Hepatocellular Carcinoma Patients
Published on: September 20, 2020
Clinical study of arterial anatomic variations for transradial coronary procedure in Chinese population
Bin Nie1, Yu-jie Zhou, Guo-zhong Li
1Department of Cardiology, Beijing Anzhen Hospital, Capital Medical University, Beijing 100029, China.
Insights
Anatomic variations in the radial artery are common in the Chinese population, impacting transradial intervention success rates. Understanding these variations is key to improving procedural outcomes and reducing complications.
Area of Science:
- Cardiovascular Interventions
- Vascular Anatomy
- Medical Imaging
Background:
- The radial artery is a preferred access site for coronary interventions.
- Limited data exists on radial artery anatomy in the Chinese population.
- Anatomical variations may influence transradial coronary procedures.
Purpose of the Study:
- To evaluate the incidence of anomalous radial artery patterns in Chinese patients.
- To assess the clinical significance of these variations on transradial intervention outcomes.
- To identify factors influencing procedural success and complications.
Main Methods:
- Coronary angiography (CA) and upper limb artery angiography were performed in approximately 3000 cases.
- Data on radial artery branch anomalies, tortuosity, and procedural characteristics were analyzed.
- Procedure success was defined as completion of CA or percutaneous coronary intervention (PCI) via the initial radial artery approach.
Main Results:
- The overall success rate for transradial intervention (TRI) was 96.6%.
- Anatomic variations were observed in 20.3% of patients, including tortuosity, hypoplasia, and abnormal origins.
- Procedural success rates were significantly lower in patients with variations (93.0%) compared to those without (97.6%).
Conclusions:
- Anatomical variations of the radial artery are prevalent and pose a significant limitation to the transradial approach.
- Understanding these variations and employing specific techniques can help overcome challenges.
- Optimizing instrument selection and procedural techniques can reduce the learning curve and improve outcomes.
Background:
The radial artery is currently regarded as a useful approach for coronary intervention procedures. Adequate anatomical information of the radial artery should be helpful in performing transradial coronary procedures. Few data about the Chinese population have been obtained in this field. Therefore, we tried to evaluate the incidence and clinical significance of anomalous patterns, and their influence on the intervention procedure.
Methods:
In an estimated sample of 3000 cases, radial artery and subclavical artery angiography were performed after insertion of the sheath and coronary angiography (CA). The evaluable data including branch anomaly, tortuosity of the radial artery and procedural characteristics were analyzed. The procedure success was defined as CA or percutaneous coronary intervention (PCI) completed with the initial radial artery approach without changing to other routes.
Results:
In this study, 1897 cases of CA was undertaken and 1103 cases of CA combined with PCI were performed. The success rate of transradial intervention (TRI) was 96.6% (2899/3000). The approach in 44 cases was changed to the contralateral radial artery and 57 cases were changed to the brachial artery or femoral artery due to failure with the initial radial artery approach. The angiography of the upper limb artery was performed in all cases. Anatomic variations of upper limb arteries were noted in 610 patients (20.3%), which included tortuous configurations of the radial artery (5.0%), hypoplasias (2.2%), radioulnar loop (1.1%), abnormal origin of the radial artery (7.7%), stenosis of radial artery (1.4%), a tortuous configuration of the brachial artery (0.9%), a tortuous configurations of the subclavian artery (1.9%), lusoria subclavian artery (0.1%), and subclavian artery occlusion (0.03%). The procedural success rate in the normal population was higher than in the variation group (97.6% vs 93.0%, P < 0.001). In addition, other procedural outcomes and incidence of complications except radial artery occlusion were also significantly superior to variation group.
Conclusions:
Anatomic variations of the radial artery were common, making up an important limitation in the trans-radial approach. Selection of appropriate instruments and understanding some tips and tricks were helpful to overcome the obstacles and effectively reduce the learning curve.
Related Concept Videos
01:30Acute Coronary Syndrome III: Diagnostic Studies
01:25Imaging Studies for Cardiovascular System VI: Calcium -Scoring CT