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ACRA Perfusion Study.

Maarten A H van Leeuwen1,2, Dirk J van der Heijden1,3, Maurits R Hollander1

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Circulation. Cardiovascular Interventions
|April 2, 2019
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Summary
This summary is machine-generated.

Transradial intervention (TRI) temporarily reduces digital perfusion in both hands. However, this reduction does not impact long-term hand function or arterial supply variations, indicating TRI is safe.

Keywords:
angiographyhandperfusion imagingradial arterythumb

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Area of Science:

  • Cardiovascular Interventions
  • Vascular Surgery
  • Hand Surgery

Background:

  • Transradial intervention (TRI) is a minimally invasive procedure.
  • Potential impairment of digital perfusion and subsequent hand dysfunction following TRI is a concern.
  • The impact of TRI on digital perfusion and hand function, considering collateral circulation, remains under-investigated.

Purpose of the Study:

  • To investigate the effect of transradial intervention (TRI) on digital perfusion.
  • To assess the influence of collateral arterial network variations on perfusion.
  • To evaluate the impact of TRI on hand dysfunction.

Main Methods:

  • Laser Doppler perfusion imaging was used to measure digital perfusion at various stages: baseline, during radial access, and TR band application.
  • Angiography assessed hand circulation, and the QuickDASH questionnaire evaluated upper extremity function.
  • Comparison of perfusion between the access (homolateral) and non-access (contralateral) thumbs was a primary outcome.

Main Results:

  • A significant reduction in digital perfusion was observed in both thumbs during radial access and TR band application.
  • No significant difference in perfusion was found between the homolateral and contralateral thumbs during radial access.
  • Reduced thumb perfusion during TRI was not linked to superficial palmar arch incompleteness or long-term hand dysfunction.

Conclusions:

  • Transradial intervention (TRI) is a safe procedure.
  • While TRI temporarily reduces digital perfusion in both hands, it does not lead to lasting hand dysfunction.
  • Perfusion deficits are not associated with arterial supply variations, confirming TRI's safety profile.