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Radial artery neointimal hyperplasia after transradial PCI-Serial optical coherence tomography volumetric study
Petr Kala1, Jan Kanovsky1, Tereza Novakova1
1Department of Internal Medicine and Cardiology, University Hospital Brno and Medical Faculty of Masaryk University, Brno, Czech Republic.
Insights
Transradial catheterization (TRC) increases radial artery intimal volume and decreases lumen volume after percutaneous coronary interventions (PCI). Optical coherence tomography (OCT) serial imaging confirmed these intimal changes, with no identified clinical factors influencing the process.
Area of Science:
- Cardiovascular Imaging
- Interventional Cardiology
- Vascular Biology
Background:
- Transradial catheterization (TRC) is a preferred access site for percutaneous coronary interventions (PCI).
- Previous studies suggest increased radial artery (RA) intimal thickness after TRC.
- Serial assessment of RA intimal changes using intravascular imaging is warranted.
Purpose of the Study:
- To evaluate intimal changes in the radial artery (RA) after transradial percutaneous coronary interventions (PCI).
- To assess changes in RA intimal and lumen volume using serial optical coherence tomography (OCT) imaging.
- To identify clinical factors associated with RA intimal changes post-PCI.
Main Methods:
- 100 patients with non-ST-elevation myocardial infarction (nSTEMI) undergoing PCI via TRC were included.
- Optical coherence tomography (OCT) imaging of the RA was performed immediately post-PCI and at 9-month follow-up.
- Volumetric analysis of RA intimal layer and lumen dimensions was conducted.
Main Results:
- A significant increase in median RA intimal volume from 33.9 mm³ to 39.0 mm³ (p<0.001) was observed.
- A significant decrease in median RA lumen volume from 356.3 mm³ to 304.7 mm³ (p<0.001) was noted.
- No clinical factors were found to significantly influence RA volume changes.
Conclusions:
- Serial OCT imaging demonstrates significant intimal thickening and lumen narrowing in the radial artery after transradial PCI.
- These vascular changes occur without identifiable influencing clinical factors.
- Further research may explore the long-term implications of these findings.
Aims:
Transradial catheterization (TRC) is a dominant access site for coronary catheterization and percutaneous coronary interventions (PCI) in many centers. Previous studies reported higher intimal thickness of the radial artery (RA) wall in patients with a previous history of TRC. In this investigation the aim was to assess the intimal changes of RA using the optical coherence tomography (OCT) intravascular imaging in a serial manner.
Methods And Results:
100 patients with the diagnosis of non-ST-elevation myocardial infarction (nSTEMI) treated by PCI were enrolled (6 patients were excluded from this analysis because of occluded RA at follow-up [2 patients] and insufficient quality of OCT images [4 patients]). An 54mm long OCT run of the RA was performed immediately after the index PCI and repeated 9 months later. Volumetric analyses of the intimal layer and lumen changes were conducted. Median intimal volume at baseline versus 9 months was 33.9mm3 (19.0; 69.4) versus 39.0mm3 (21.7; 72.6) (p<0.001); and median arterial lumen volume was 356.3mm3 (227.8; 645.3) versus 304.7mm3 (186.1; 582.7) (p<0.001). There was no significant difference in the effect of any clinical factor on the RA volume changes.
Conclusions:
OCT volumetric analyses at baseline and 9 months showed a significant increase in the radial artery intimal layer volume and a decrease in lumen volume after transradial PCI. No significant factors affecting this process were identified.
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