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Impact of Ischemic Preconditioning Preceding Transradial Access for Coronary Angiography on Preventing Postoperative
Linhui He1,2,3, Weiwei Zhang1,2,3, Yingying Huang1,2,3
1Department of Cardiology, Daping Hospital, Third Military Medical University, Chongqing, China.
Insights
Ischemic preconditioning before transradial access (TRA) for coronary angiography or intervention significantly reduces postoperative pain, swelling, and bruising. This simple technique improves patient recovery after these common cardiac procedures.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Vascular Surgery
Background:
- Transradial access (TRA) is a recommended approach for coronary angiography (CAG) and percutaneous coronary intervention (PCI).
- Postoperative complications like pain, swelling, bleeding, and bruising can occur following TRA procedures.
- Effective strategies to mitigate these complications are crucial for patient well-being.
Purpose of the Study:
- To evaluate the efficacy of ischemic preconditioning using a compression tourniquet before TRA.
- To determine if this intervention can prevent or reduce common postoperative complications.
Main Methods:
- A randomized controlled trial involving 1227 patients undergoing selective transradial CAG or PCI.
- Patients were assigned to either a control group or an ischemic preconditioning group.
- The intervention group received radial artery ischemic preconditioning prior to the procedure; outcomes were assessed at 4 and 24 hours postoperatively.
Main Results:
- The ischemic preconditioning group showed significantly reduced swelling, pain, and bleeding at 4 hours post-procedure.
- Bruising severity at 24 hours was also significantly lower in the ischemic preconditioning group compared to the control group.
- These findings indicate a clear benefit of the preconditioning intervention.
Conclusions:
- Ischemic preconditioning with a compression tourniquet is an effective method to reduce postoperative complications.
- This technique offers a promising approach to enhance patient recovery after transradial coronary procedures.
- Further research may explore long-term benefits and broader applications.
Background:
Transradial access (TRA) has been endorsed as a Class 1a recommendation for coronary angiography (CAG) or percutaneous coronary intervention (PCI). However, some patients suffer from postoperative complications such as pain, swelling, bleeding and bruising.
Aims:
To investigate the effect of ischemic preconditioning with the compression tourniquet preceding TRA for CAG or PCI on preventing postoperative complications.
Methods:
A total of 1227 inpatients scheduled for selective transradial CAG or PCI from September 2021 to March 2022 at the Department of Cardiology, Daping Hospital, were enrolled. Patients were randomly divided into a control group (582 cases) and an ischemic preconditioning group (645 cases). The control group received routine preoperative education and postoperative care, while the ischemic preconditioning group underwent additional radial artery ischemic preconditioning training before operation. Patients were evaluated for swelling (palm/finger and arm), pain, and bleeding at 4 h, as well as bruising severity was assessed at 24 h postoperatively.
Results:
The swelling, pain, bleeding at 4 h and bruising severity at 24 h in the ischemic preconditioning group were significantly alleviated compared to those in the control group postoperatively (p < 0.05).
Conclusion:
Ischemic preconditioning with the compression tourniquet can reduce postoperative complications in the limb of patients undergoing transradial CAG or PCI.
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