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Zus AS, Crișan S, Luca S, Nișulescu D, Valcovici M, Pătru O, Lazăr MA, Văcărescu C, Gaiță D, Luca CT. Radial Artery Spasm-A Review on Incidence, Prevention and Treatment. Diagnostics (Basel) 2024; 14:1897. [PMID: 39272682 PMCID: PMC11394041 DOI: 10.3390/diagnostics14171897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2024] [Revised: 08/23/2024] [Accepted: 08/26/2024] [Indexed: 09/15/2024] Open
Abstract
Radial artery spasm (RAS) is a common complication associated with transradial access (TRA) for coronary interventions, particularly affecting elderly patients in whom radial access is preferred due to its benefits in reducing bleeding complications, improving clinical outcomes, and lowering long-term costs. This review examines the incidence, prevention, and treatment of RAS. Methods included an online search of PubMed and other databases in early 2024, analyzing meta-analyses, reviews, studies, and case reports. RAS is characterized by a sudden narrowing of the radial artery due to psychological and mechanical factors with incidence reports varying up to 51.3%. Key risk factors include patient characteristics like female sex, age, and small body size as well as procedural factors such as emergency procedures and the use of multiple catheters. Preventive measures include using distal radial access, hydrophilic sheaths, and appropriate catheter sizes. Treatments involve the intraarterial administration of nitroglycerine and verapamil as well as mechanical methods like balloon-assisted tracking. This review underscores the need for standardizing RAS definitions and emphasizes the importance of operator experience and patient management in reducing RAS incidence and improving procedural success.
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Affiliation(s)
- Adrian Sebastian Zus
- Cardiology Department, "Victor Babes" University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Simina Crișan
- Cardiology Department, "Victor Babes" University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Silvia Luca
- Cardiology Department, "Victor Babes" University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Daniel Nișulescu
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
- Department of Histology, Faculty of Medicine, Vasile Goldis Western University of Arad, 310025 Arad, Romania
| | - Mihaela Valcovici
- Cardiology Department, "Victor Babes" University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Oana Pătru
- Cardiology Department, "Victor Babes" University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Mihai-Andrei Lazăr
- Cardiology Department, "Victor Babes" University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Cristina Văcărescu
- Cardiology Department, "Victor Babes" University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Dan Gaiță
- Cardiology Department, "Victor Babes" University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
| | - Constantin-Tudor Luca
- Cardiology Department, "Victor Babes" University of Medicine and Pharmacy, 2 Eftimie Murgu Sq., 300041 Timisoara, Romania
- Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
- Research Center of the Institute of Cardiovascular Diseases Timisoara, 13A Gheorghe Adam Street, 300310 Timisoara, Romania
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Zhao Y, Chen T, Yang L, Mao W, Wan Y, Zhang L, Ding H, Cai G, Huang Z. Is catheterization via distal transradial access feasible in children? From vessel diameter perspective. Front Cardiovasc Med 2024; 11:1428083. [PMID: 39156135 PMCID: PMC11327814 DOI: 10.3389/fcvm.2024.1428083] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2024] [Accepted: 07/23/2024] [Indexed: 08/20/2024] Open
Abstract
Background Distal radial artery (DRA) access is an infrequent alternative access for pediatric catheterization. The feasibility of using the DRA for arterial catheterization in children depends on the vessel's size. Objectives This study aims to provide a reference for pediatric catheterization via DRA access by evaluating the diameter of the DRA in the anatomic snuffbox (AS). Methods We conducted a retrospective review of clinical and vascular ultrasound data of 412 children (ages 3-12) who were scheduled for arterial blood gas analysis via the DRA due to serious respiratory diseases between June 2023 and October 2023. Results The corrected DRA diameter in the AS was 1.97 ± 0.37 mm overall, with no significant difference between males (1.98 ± 0.38 mm) and females (1.95 ± 0.35 mm) (p = 0.457). The anteroposterior, transverse, and corrected DRA diameters increased significantly with age (p < 0.05). The DRA diameter was significantly smaller than the proximal radial artery (PRA) diameter (1.97 ± 0.37 mm vs. 2.05 ± 0.33 mm, p < 0.001) but larger than the ulnar artery (UA) diameter (1.97 ± 0.37 mm vs. 1.88 ± 0.33 mm, p < 0.001). The proportions of patients with a DRA diameter greater than 2.0 mm and 1.5 mm were 38.83% and 86.89%, respectively. The proportions of patients with DRA diameters >2.0 mm and >1.5 mm increased significantly with age (p < 0.01). The percentages of individuals with a DRA/PRA ratio ≥1.0 were 55.10% overall, 52.12% in males, and 58.60% in females. DRA diameter showed significant correlations with age (r = 0.275, p < 0.01), height (r = 0.319, p < 0.01), weight (r = 0.319, p < 0.01), BMI (r = 0.241, p < 0.01), wrist circumference (r = 0.354, p < 0.01), PRA diameter (r = 0.521, p < 0.01), and UA diameter (r = 0.272, p < 0.01). Conclusion The DRA diameter in children increases with age and size, making cardiac catheterization is theoretically feasible. Preoperative evaluation of the vessel diameter and intraoperative ultrasound-guided intervention are recommended for paediatric catheterization via the DRA access.
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Affiliation(s)
- Yidong Zhao
- Department of Pediatrics, The Second People’s Hospital of Changzhou, Affiliated Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
| | - Tao Chen
- Department of Cardiology, Wujin Hospital Affiliated with Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
| | - Ling Yang
- Department of Respiratory and Critical Care Medicine, The Affiliated Changzhou Second People’s Hospital of Nanjing Medical University, Changzhou, China
| | - Wenjie Mao
- Department of Pediatrics, The Second People’s Hospital of Changzhou, Affiliated Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
| | - Yu Wan
- Department of Pediatrics, The Second People’s Hospital of Changzhou, Affiliated Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
| | - Liwen Zhang
- Department of Pediatrics, The Second People’s Hospital of Changzhou, Affiliated Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
| | - Heng Ding
- Department of Pediatrics, The Second People’s Hospital of Changzhou, Affiliated Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
| | - Gaojun Cai
- Department of Cardiology, Wujin Hospital Affiliated with Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou, Jiangsu, China
| | - Zhiying Huang
- Department of Pediatrics, The Second People’s Hospital of Changzhou, Affiliated Hospital of Nanjing Medical University, Changzhou, Jiangsu, China
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Achim A, Ruzsa Z. The occlusion rates after distal radial access: how to multiply your bullets. BMC Med 2024; 22:246. [PMID: 38872166 PMCID: PMC11170839 DOI: 10.1186/s12916-024-03470-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2024] [Accepted: 06/05/2024] [Indexed: 06/15/2024] Open
Affiliation(s)
- Alexandru Achim
- Department of Cardiology, Niculae Stancioiu" Heart Institute, University of Medicine and Pharmacy "Iuliu Hatieganu", Motilor 19-21, Cluj-Napoca-Napoca, 400001, Romania.
- Internal Medicine Department, Division of Invasive Cardiology, University of Szeged, Szeged, Hungary.
| | - Zoltan Ruzsa
- Internal Medicine Department, Division of Invasive Cardiology, University of Szeged, Szeged, Hungary
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Didagelos M, Pagiantza A, Papazoglou AS, Moysidis DV, Petroglou D, Daios S, Anastasiou V, Theodoropoulos KC, Kouparanis A, Zegkos T, Kamperidis V, Kassimis G, Ziakas A. Incidence and Prognostic Factors of Radial Artery Occlusion in Transradial Coronary Catheterization. J Clin Med 2024; 13:3276. [PMID: 38892987 PMCID: PMC11173088 DOI: 10.3390/jcm13113276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2024] [Revised: 05/27/2024] [Accepted: 05/27/2024] [Indexed: 06/21/2024] Open
Abstract
Background/Objectives: Radial artery occlusion (RAO) is the most common complication of transradial coronary catheterization. In this study, we aimed to evaluate the incidence of RAO and identify the risk factors that predispose patients to it. Methods: We conducted an investigator-initiated, prospective, multicenter, open-label study involving 1357 patients who underwent cardiac catheterization via the transradial route for angiography and/or a percutaneous coronary intervention (PCI). Univariate and multivariate logistic regression analyses were performed to identify potential predictors of RAO occurrence. Additionally, a subgroup analysis only for patients undergoing PCIs was performed. Results: The incidence of RAO was 9.5% overall, 10.6% in the angiography-only group and 6.2% in the PCI group. Independent predictors of RAO were as follows: (i) the female gender (aOR = 1.72 (1.05-2.83)), (ii) access site cross-over (aOR = 4.33 (1.02-18.39)), (iii) increased total time of the sheath in the artery (aOR = 1.01 (1.00-1.02)), (iv) radial artery spasms (aOR = 2.47 (1.40-4.36)), (v) the presence of a hematoma (aOR = 2.28 (1.28-4.06)), (vi) post-catheterization dabigatran use (aOR = 5.15 (1.29-20.55)), (vii) manual hemostasis (aOR = 1.94 (1.01-3.72)) and (viii) numbness at radial artery ultrasound (aOR = 8.25 (1.70-40)). Contrariwise, two variables were independently associated with increased odds for radial artery patency (RAP): (i) PCI performance (aOR = 0.19 (0.06-0.63)), and (ii) a higher dosage of intravenous heparin per patient weight (aOR = 0.98 (0.96-0.99)), particularly, a dosage of >50 IU/kg (aOR = 0.56 (0.31-1.00)). In the PCI subgroup, independent predictors of RAO were as follows: (i) radial artery spasms (aOR = 4.48 (1.42-14.16)), (ii) the use of intra-arterial nitroglycerin as a vasodilator (aOR = 7.40 (1.67-32.79)) and (iii) the presence of symptoms at echo (aOR = 3.80 (1.46-9.87)), either pain (aOR = 2.93 (1.05-8.15)) or numbness (aOR = 4.66 (1.17-18.57)). On the other hand, the use of intra-arterial verapamil as a vasodilator (aOR = 0.17 (0.04-0.76)) was independently associated with a greater frequency of RAP. Conclusions: The incidence of RAO in an unselected, all-comers European population after transradial coronary catheterization for angiography and/or PCIs is similar to that reported in the international literature. Several RAO prognostic factors have been confirmed, and new ones are described. The female gender, radial artery trauma and manual hemostasis are the strongest predictors of RAO. Our results could help in the future identification of patients at higher risk of RAO, for whom less invasive diagnostic procedures maybe preferred, if possible.
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Affiliation(s)
- Matthaios Didagelos
- 1st Cardiology Department, AHEPA University General Hospital, 54636 Thessaloniki, Greece; (A.P.); (S.D.); (V.A.); (K.C.T.); (A.K.); (T.Z.); (V.K.); (A.Z.)
| | - Areti Pagiantza
- 1st Cardiology Department, AHEPA University General Hospital, 54636 Thessaloniki, Greece; (A.P.); (S.D.); (V.A.); (K.C.T.); (A.K.); (T.Z.); (V.K.); (A.Z.)
- 424 General Military Hospital, 56429 Thessaloniki, Greece; (D.V.M.); (D.P.)
| | | | | | | | - Stylianos Daios
- 1st Cardiology Department, AHEPA University General Hospital, 54636 Thessaloniki, Greece; (A.P.); (S.D.); (V.A.); (K.C.T.); (A.K.); (T.Z.); (V.K.); (A.Z.)
| | - Vasileios Anastasiou
- 1st Cardiology Department, AHEPA University General Hospital, 54636 Thessaloniki, Greece; (A.P.); (S.D.); (V.A.); (K.C.T.); (A.K.); (T.Z.); (V.K.); (A.Z.)
| | - Konstantinos C. Theodoropoulos
- 1st Cardiology Department, AHEPA University General Hospital, 54636 Thessaloniki, Greece; (A.P.); (S.D.); (V.A.); (K.C.T.); (A.K.); (T.Z.); (V.K.); (A.Z.)
| | - Antonios Kouparanis
- 1st Cardiology Department, AHEPA University General Hospital, 54636 Thessaloniki, Greece; (A.P.); (S.D.); (V.A.); (K.C.T.); (A.K.); (T.Z.); (V.K.); (A.Z.)
| | - Thomas Zegkos
- 1st Cardiology Department, AHEPA University General Hospital, 54636 Thessaloniki, Greece; (A.P.); (S.D.); (V.A.); (K.C.T.); (A.K.); (T.Z.); (V.K.); (A.Z.)
| | - Vasileios Kamperidis
- 1st Cardiology Department, AHEPA University General Hospital, 54636 Thessaloniki, Greece; (A.P.); (S.D.); (V.A.); (K.C.T.); (A.K.); (T.Z.); (V.K.); (A.Z.)
| | - George Kassimis
- 2nd Department of Cardiology, Hippokration Hospital, 54942 Thessaloniki, Greece;
| | - Antonios Ziakas
- 1st Cardiology Department, AHEPA University General Hospital, 54636 Thessaloniki, Greece; (A.P.); (S.D.); (V.A.); (K.C.T.); (A.K.); (T.Z.); (V.K.); (A.Z.)
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Chen T, Li L, Li F, Lu W, Shi G, Li W, Yang A, Huang H, Xiao J, Zhang Q, Gu J, Xue S, Zhang L, Li L, Xu L, Ji R, Wang H, Cai G. Comparison of long-term radial artery occlusion via distal vs. conventional transradial access (CONDITION): a randomized controlled trial. BMC Med 2024; 22:62. [PMID: 38331793 PMCID: PMC10854098 DOI: 10.1186/s12916-024-03281-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Accepted: 02/01/2024] [Indexed: 02/10/2024] Open
Abstract
BACKGROUND The distal transradial access (dTRA) has become an attractive and alternative access to the conventional transradial access (TRA) for cardiovascular interventional diagnosis and/or treatment. There was a lack of randomized clinical trials to evaluate the effect of the dTRA on the long-term radial artery occlusion (RAO). METHODS This was a prospective, randomized controlled study. The primary endpoint was the incidence of long-term RAO at 3 months after discharge. The secondary endpoints included the successful puncture rate, puncture time, and other access-related complications. RESULTS The incidence of long-term RAO was 0.8% (3/361) for dTRA and 3.3% (12/365) for TRA (risk ratio = 0.25, 95% confidence interval = 0.07-0.88, P = 0.02). The incidence of RAO at 24 h was significantly lower in the dTRA group than in the TRA group (2.5% vs. 6.7%, P < 0.01). The puncture success rate (96.0% vs. 98.5%, P = 0.03) and single puncture attempt (70.9% vs. 83.9%, P < 0.01) were significantly lower in the dTRA group than in the TRA group. However, the number of puncture attempts and puncture time were higher in the dTRA group. The dTRA group had a lower incidence of bleeding than the TRA group (1.5% vs. 6.0%, P < 0.01). There was no difference in the success rate of the procedure, total fluoroscopy time, or incidence of other access-related complications between the two groups. In the per-protocol analysis, the incidence of mEASY type ≥ II haematoma was significantly lower in the dTRA group, which was consistent with that in the as-treated analysis. CONCLUSIONS The dTRA significantly reduced the incidence of long-term RAO, bleeding or haematoma. TRIAL REGISTRATION ClinicalTrials.gov identifer: NCT05253820.
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Affiliation(s)
- Tao Chen
- Department of Cardiology, Wujin Hospital Affiliated With Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, Jiangsu Province, China
| | - Lamei Li
- Department of Cardiology, Wujin Hospital Affiliated With Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, Jiangsu Province, China
| | - Feng Li
- Department of Cardiology, Wujin Hospital Affiliated With Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, Jiangsu Province, China
| | - Wei Lu
- Department of Cardiology, Wujin Hospital Affiliated With Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, Jiangsu Province, China
| | - Ganwei Shi
- Department of Cardiology, Wujin Hospital Affiliated With Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, Jiangsu Province, China
| | - Wenhua Li
- Department of Cardiology, Wujin Hospital Affiliated With Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, Jiangsu Province, China
| | - Anni Yang
- Department of Cardiology, Wujin Hospital Affiliated With Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, Jiangsu Province, China
| | - Hui Huang
- Department of Cardiology, Jiangyin Hospital of Traditional Chinese Medicine, Wuxi, 214400, Jiangsu Province, China
| | - Jianqiang Xiao
- Department of Cardiology, Wujin Hospital Affiliated With Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, Jiangsu Province, China
| | - Qiuwei Zhang
- Department of Catheter Room, Wujin Hospital Affiliated With Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, Jiangsu Province, China
| | - Jun Gu
- Department of Cardiology, Wujin Hospital Affiliated With Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, Jiangsu Province, China
| | - Sheliang Xue
- Department of Cardiology, Wujin Hospital Affiliated With Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, Jiangsu Province, China
| | - Liuyan Zhang
- Department of Cardiology, Wujin Hospital Affiliated With Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, Jiangsu Province, China
| | - Li Li
- Department of Cardiology, Wujin Hospital Affiliated With Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, Jiangsu Province, China
| | - Lingxia Xu
- Department of Cardiology, Wujin Hospital Affiliated With Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, Jiangsu Province, China
| | - Rongrong Ji
- Department of Cardiology, Wujin Hospital Affiliated With Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, Jiangsu Province, China
| | - Haibo Wang
- Peking University Clinical Research Institute, Peking University First Hospital, Beijing, 100191, China.
- Key Laboratory of Epidemiology of Major Diseases (Peking University), Ministry of Education, 38 Xueyuan St, Haidian District, Beijing, 100191, China.
| | - Gaojun Cai
- Department of Cardiology, Wujin Hospital Affiliated With Jiangsu University, The Wujin Clinical College of Xuzhou Medical University, Changzhou, 213017, Jiangsu Province, China.
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Seecheran NA, Leyva Quert AY, Seecheran VK, Seecheran RV, Katwaroo A, Jagdeo CL, Rafeeq S, Ramcharan P, Peram L, Ramlal R, Ramlackhansingh A, Giddings S, Sandy S. Effectiveness and Safety of Left Distal Transradial Access in Coronary Procedures in the Caribbean. Cureus 2024; 16:e54601. [PMID: 38384868 PMCID: PMC10880138 DOI: 10.7759/cureus.54601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/20/2024] [Indexed: 02/23/2024] Open
Abstract
INTRODUCTION This retrospective study investigated the effectiveness and safety of left distal transradial access (LDTRA) in patients with cardiovascular disease in Trinidad undergoing coronary angiography (CAG) or percutaneous coronary intervention (PCI). METHOD Procedural parameters, including technical success and safety outcomes such as vascular complications and radial artery occlusion (RAO), were assessed in 111 consecutive patients undergoing CAG or PCI from January 2023 to June 2023 at the Eric Williams Medical Sciences Complex, Trinidad and Tobago. Eighty-eight patients underwent LDTRA, while 23 received left transradial access (LTRA). RESULTS There was no difference in procedural success with LDTRA compared to LTRA, 90.9% vs. 100%, p-value 0.202, non-significant (ns). LDTRA was associated with shorter fluoroscopy times (8.4 ± 6.8 minutes vs. 12.4 ± 7.7 minutes, p-value = 0.02), procedural duration (26.7 ± 18 minutes vs. 35.8 ± 20 minutes, p-value = 0.04), and hemostasis time (142 ± 41 minutes vs. 186 ± 44 minutes, p-value < 0.05). There were no significant differences in procedural-related complications (8% for LDTRA vs. 4.3% for LTRA, p-value = 0.476, ns). There were no reported cases of RAO. In the subgroup of patients with prior coronary artery bypass grafting (CABG), the fluoroscopy and procedure times were similar for both access sites; however, LDTRA was associated with a shorter hemostasis time (128 ± 30 minutes vs. 194 ± 39 minutes, p-value = 0.01). CONCLUSIONS LDTRA is effective and safe for coronary procedures and is associated with a shorter hemostasis time. This study may prove clinically pertinent in a limited-resource Caribbean setting.
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Affiliation(s)
- Naveen A Seecheran
- Clinical Medical Sciences, The University of the West Indies, St. Augustine, TTO
| | | | | | | | - Arun Katwaroo
- Internal Medicine, Trinidad Institute of Medical Technology, St. Augustine, TTO
| | - Cathy-Lee Jagdeo
- Cardiology, Eric Williams Medical Sciences Complex, Mt. Hope, TTO
| | - Salma Rafeeq
- Cardiology, Eric Williams Medical Sciences Complex, Mt. Hope, TTO
| | - Priya Ramcharan
- Cardiology, Eric Williams Medical Sciences Complex, Mt. Hope, TTO
| | | | - Ravi Ramlal
- Cardiology, Eric Williams Medical Sciences Complex, Mt. Hope, TTO
| | - Anil Ramlackhansingh
- Clinical Medical Sciences, The University of the West Indies, St. Augustine, TTO
| | - Stanley Giddings
- Clinical Medical Sciences, The University of the West Indies, St. Augustine, TTO
| | - Sherry Sandy
- Clinical Medical Sciences, The University of the West Indies, St. Augustine, TTO
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