Radial artery: how many times?

Transradial approach for diagnostic and interventional procedures is becoming common practice. It has not been well determined how many times the same radial artery can be cannulated without complications. Aim of the study was to evaluate safety, feasibility and efficacy of repeat transradial procedures.

From May 1998 to March 2009 we studied 4818 consecutive patients (75.44% male; age 64.02 +/- 11.6 Years) via radial artery by a single experienced operator.

A repeat transradial procedure through the same radial artery was performed in 670 patients: twice in 514 cases, three times in 119, four times in 25 patients, five times in 7 patients, six times in 3 patients and seven times in one patient. Repeat PCI was performed in 412 patients. 6F catheters were used in 98.11%. There was no significant difference in radial puncture success rate and vascular access time: puncture success rate was 99.23% in the initial procedure and 98.11% (5 puncture failure) in repeated transradial artery procedures, and vascular access time was 1.5 +/- 2.1 min at the initial procedure and 2.2 +/- 3.1 min at repeat (p = ns).

Failure of repeat puncture may be due to thickening of the tunica intima resulting from sheath insertion injuries or because of periarterial fibrosis at the prior radial puncture site. We believe that repeated use of the same radial artery is effective in considering its high procedural success and low complication rates in majority of patients in the hands of experienced operators.