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Impact of Transradial Catheterization on Vascular Function of the Brachial Artery Assessed by Flow-Mediated
Sadamitsu Ichijo1, Taishi Yonetsu1, Tadashi Murai1
1Department of Cardiovascular Medicine, Tsuchiura Kyodo General Hospital, Tsuchiura, Japan.
Insights
Transradial catheterization temporarily reduces brachial artery flow-mediated dilatation (FMD), but function recovers long-term. Repeated procedures do not impair this recovery, indicating resilience of vascular endothelial function.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Vascular Biology
Background:
- Limited data exists on long-term vascular function post-transradial catheterization.
- The impact of repeated transradial procedures on vascular function is not well understood.
Purpose of the Study:
- To investigate the long-term effects of transradial catheterization on brachial artery flow-mediated dilatation (FMD).
- To assess if repeated catheterizations via the same radial artery affect FMD recovery.
Main Methods:
- Prospective enrollment of 50 patients undergoing diagnostic coronary angiography via radial access.
- FMD measurements were taken before, 24 hours after, and long-term (mean 32 months) post-catheterization.
- Comparison of follow-up FMD between patients with single vs. multiple procedures via the same radial artery.
Main Results:
- Brachial artery FMD significantly decreased post-catheterization but recovered to baseline levels at long-term follow-up.
- No significant difference in follow-up FMD was observed between single and multiple catheterization groups (p=0.06).
- No predictive factors for worse long-term FMD were identified.
Conclusions:
- Transradial catheterization causes temporary brachial artery FMD reduction, with full recovery at long-term follow-up.
- Repeated transradial procedures do not appear to compromise brachial artery endothelial function recovery.
- The brachial artery demonstrates potential for functional recovery after multiple transradial interventions.
Background:
Few studies have evaluated long-term vascular function after radial access catheterization. Furthermore, the impact of repeated catheterization remains unknown. We investigated flow-mediated dilatation (FMD) of the brachial artery after transradial catheterization.
Methods:
We prospectively enrolled 50 patients with suspected coronary artery disease referred for diagnostic coronary angiography. No ad-hoc percutaneous coronary interventions (PCI) had been performed at the time of the index procedure. In 30 patients (63.8%), PCI and/or repeated follow-up diagnostic catheterization were subsequently performed via the radial artery used at the index catheterization. FMD was successfully measured before catheterization, at 24 h after catheterization, and after long-term follow-up (mean, 32 months; range, 24-43) in 47 patients. FMD at follow-up was compared between patients receiving only one procedure and those receiving multiple procedures via the same arteries.
Results:
FMD was significantly decreased after catheterization and recovered well in long-term follow-up (3.7 ± 1.6%, 3.0 ± 1.7%, and 3.9 ± 1.6%). There was no significant difference in follow-up FMD between the patients undergoing single catheterization and those with multiple procedures (3.4 ± 1.3 vs. 4.3 ± 1.7, p = 0.06). When the patients were divided into two groups according to the median follow-up FMD value, no significant predictive factor was identified for worse FMD.
Conclusions:
After transradial catheterization, FMD of the brachial artery temporarily decreased but recovered in long-term follow-up. Recovery of FMD was not jeopardized by repeated catheterization, which suggests the potential of the brachial artery to recover endothelial function after repeated transradial procedures.
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