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Prevalence of abnormal upper limb arterial anatomy and its correlation with access failure during transradial
Sripad V Khairnar1, Ranjit Kumar Nath1, Balram Yadav1
1Department of Cardiology, ABVIMS & Dr. Ram Manohar Lohia Hospital, New Delhi 110001, India.
Insights
Abnormal upper limb arterial anatomy frequently causes access failure during transradial coronary angiography. Understanding these anatomical variations is key to improving procedural success rates.
Area of Science:
- Cardiovascular Imaging
- Interventional Cardiology
- Anatomical Studies
Background:
- Transradial coronary angiography (CAG) is a common procedure.
- Access failure can complicate transradial CAG.
- Upper limb arterial anatomy variations may impact access.
Purpose of the Study:
- Determine the prevalence of abnormal upper limb arterial anatomy.
- Investigate the correlation between anatomical variations and access failure in transradial CAG.
Main Methods:
- Prospective observational study of 1512 patients undergoing transradial CAG.
- Angiographic assessment of upper limb arteries when guidewire or catheter path was abnormal or obstructed.
- Data collection on anatomical variations and access failure events.
Main Results:
- 5.29% of patients (80/1512) exhibited abnormal upper limb arterial anatomy.
- Common variations included radio-ulnar loop (1.46%), tortuous arteries (1.25%), and high radial artery origin (0.66%).
- Access failure occurred in 4.4% of patients, with 64.17% attributed to anatomical abnormalities.
Conclusions:
- Abnormal upper limb arterial anatomy is a significant cause of access failure in transradial CAG.
- Identifying these variations can help predict and potentially mitigate procedural complications.
- Further research into managing access in patients with anatomical variations is warranted.
Objective:
The study aimed at to find out prevalence of abnormal upper limb arterial anatomy and its correlation with access failure during transradial coronary angiography.
Method:
This was a prospective observational study of 1512 patients who had undergone transradial coronary angiography (CAG). Angiographic assessment of upper limb arterial tree was performed when the angiographic guidewire or the diagnostic catheter followed an abnormal path or got stuck in its course.
Results:
About 5.29% patients (80/1512) were noted to have abnormal upper limb arterial anatomy. The most common abnormality detected were radio-ulnar loop in 22 (1.46%) patients, tortuous upper limb arteries 19 (1.25%) and abnormal high origin of radial artery 10 (0.66%) patients. Access failure was encountered in 4.4% (67/1512) of total patients and 64.17% (43/67) access failure was due to abnormal upper limb arterial anatomy.
Conclusion:
Abnormal upper limb arterial anatomy was the most common cause of access failure in transradial coronary angiography in this study.
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