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Incidence and predictors of radial artery occlusion after transradial coronary catheterization

Mohamed A Sadaka1, Waleed Etman2, Walid Ahmed2

  • 1Cardiology and Angiology Department, Faculty of Medicine, Alexandria University, Alexandria, Egypt. mohsadaka2000@yahoo.com.

The Egyptian Heart Journal : (EHJ) : Official Bulletin of the Egyptian Society of Cardiology
|October 30, 2019
PubMed

Insights

Radial artery occlusion (RAO) affects nearly a third of patients after transradial approach (TRA) procedures. Female gender, older age, and manual compression are key predictors, while short TR band use improves radial artery patency.

Area of Science:

  • Cardiology
  • Vascular Surgery
  • Interventional Cardiology

Background:

  • Radial artery occlusion (RAO) is a significant complication of the transradial approach (TRA).
  • RAO is often considered the "Achilles' heel" of transradial techniques.
  • Understanding RAO incidence and predictors is crucial for patient outcomes.

Purpose of the Study:

  • To determine the incidence of radial artery occlusion (RAO) after transradial coronary catheterization.
  • To identify independent predictors of RAO following percutaneous coronary interventions (PCI) via TRA.
  • To evaluate the impact of hemostasis duration on radial artery patency.

Main Methods:

  • Prospective study of 164 patients undergoing PCI via TRA with 6-F catheters.
  • Doppler ultrasonography assessment of the radial artery (RA) on day 1 and 6 months post-procedure.
  • Multivariate analysis to identify predictors of RAO and factors influencing RA patency.

Main Results:

  • Radial artery occlusion (RAO) detected in 32.9% of patients on day 1, decreasing to 29.9% at 6 months.
  • Independent predictors of RAO include female gender, older age, manual compression, and smaller RA diameter.
  • Short hemostasis duration (2 hours) using a TR band was a potent predictor of RA patency at both time points.

Conclusions:

  • Radial artery occlusion (RAO) is a common, though often asymptomatic, complication of transradial procedures.
  • Patients with identified RAO predictors require careful management and monitoring.
  • Optimizing hemostasis strategies, like TR band use, can improve long-term radial artery patency.
Abstract

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