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Arterial anatomic variations and its influence on transradial coronary procedural outcome
Tugrul Norgaz1, Sevket Gorgulu, Sinan Dagdelen
1Cardiology Department, Acibadem University, Istanbul, Turkey.
Insights
Arterial variations impact transradial coronary procedures. These variations are linked to older patients, higher failure rates, and longer procedure times, affecting overall outcomes.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Radiology
Background:
- Transradial coronary procedures are increasingly common.
- Understanding factors influencing procedural success is crucial.
Purpose of the Study:
- To determine the frequency of arterial anatomic variations.
- To assess the relationship between these variations and coronary procedural outcomes in patients undergoing their first transradial coronary procedure.
Main Methods:
- A single-center prospective study included 1,446 patients undergoing their first transradial coronary procedure.
- Retrograde radial and subclavian arteriography were used to define arterial anatomy.
- Procedural data, including duration, device usage, contrast volume, DAP, fluoroscopy time, and complications, were recorded.
Main Results:
- Arterial variations were found in 18.6% of patients.
- Patients with variations were older, more frequently female, and experienced higher procedural failure rates (8.8% vs. 5.6%).
- Variations were associated with longer procedural duration, increased fluoroscopy time, higher contrast usage, and more minor vascular complications.
Conclusions:
- Arterial anatomic variations negatively impact transradial coronary procedural outcomes.
- These findings highlight the importance of recognizing arterial variations in interventional cardiology.
Objectives:
Our aim was to establish the frequency of arterial anatomic variations and its relation to coronary procedural outcome in patients undergoing a first transradial coronary procedure.
Methods:
This was a single center prospective study. A total of 1,446 consecutive patients undergoing their first transradial coronary procedure were recruited. Retrograde radial arteriography was performed to define radial artery anatomy. If the operator encountered serious problems during crossing the subclavian-aortic truncus, retrograde subclavian arteriography was also performed. Patient demographics; procedural data such as: total procedural duration, the number of catheters and guidewires used, the amount of contrast media usage, dose area product (DAP), and fluoroscopy time; and vascular complications were recorded.
Results:
Anatomic variations were noted in 270 patients (18.6%), and these patients were significantly older (mean age 64.4 ± 10.4 vs. 59.2 ± 10.8 years, P < 0.001) and more commonly female (46% vs. 33%, P < 0.001) with significantly higher procedural failure rates (8.8% vs. 5.6%, P = 0.006). In addition, procedural duration (P < 0.001) and fluoroscopy time (P < 0.001) were statistically longer in patients with anatomic variations. Anatomic variations also had an adverse impact on the amount of contrast agent usage (63.9 ± 28.3 mL vs. 59.1 ± 25.3 mL, P = 0.006) and minor vascular complication rate (P = 0.007).
Conclusions:
This study indicates that anatomic variation of the arterial path has an adverse impact on transradial coronary procedural outcome.
