Distal radial arterial hypertrophy after transradial intervention: A serial intravascular ultrasound study

Wakeyama, Takatoshi; Iwami, Takahiro; Tanaka, Masakazu; Harada, Nozomu; Hiratsuka, Atsushi; Nakashima, Tadaaki; Kato, Takayoshi; Kinoshita, Natsu; Takenaka, Hiroyuki; Nakamura, Yoshihide; Fujii, Shohei; Kajii, Toshiro; Yano, Masafumi

doi:10.1016/j.jjcc.2018.05.008

Cited by 8 publications

(5 citation statements)

References 16 publications

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“…Post-catheterization stenosis and occlusion of the radial artery are common and related to several factors, including female sex, age, manual compression, and radial artery diameter [50]. Wakeyama et al [51] found radial artery hypertrophy after transradial intervention by IVUS. After 6 months, the intima-media volume in patients who underwent transradial artery intervention was increased significantly, whereas the lumen volume and vessel volume decreased significantly.…”

Section: Raomentioning

confidence: 99%

Distal transradial access: a review of the feasibility and safety in cardiovascular angiography and intervention

Cai

Huang

Feng

et al. 2020

BMC Cardiovasc Disord

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Background: Transradial access (TRA) has been considered as the default choice in cardiac catheterization. Although infrequent, vascular complications of this approach remain. Recently, the distal transradial approach (dTRA) in cardiac catheterization was reported by interventionalists. Methods: We retrieved the relevant literatures and reviewed the safety and feasibility of this novel approach in cardiac catheterization. Results: The dTRA for cardiac intervention has superior safety and satisfaction. As a novel approach for cardiac catheterization, access related complications should also be considered by operators, such as RAO, radial spasm, bleeding and haematoma, and injury of the superficial branch of the radial nerve. Conclusions: The dTRA in cardiovascular angiography and intervention was safe and feasible.

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Section: Raomentioning

confidence: 99%

Distal transradial access: a review of the feasibility and safety in cardiovascular angiography and intervention

Cai

Huang

Feng

et al. 2020

BMC Cardiovasc Disord

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“…The resolutions of Doppler ultrasound in low-and high-frequencies ranging from 8 MHz to 50 MHz can detect the properties of blood flow, which can operate in A-and B-scan modes. Intravascular ultrasound catheters have permitted tomographic visualization to reveal the cross section of arterial vessels, such as coronary artery, with a diameter of <0.9 mm [39]- [41]. However, it is an invasive imaging technology for scanning the intimal layer of vessels.…”

Section: Results and Conclusionmentioning

confidence: 99%

Hemodynamic Quantitative Analysis Based on Doppler Ultrasound for Arteriovenous Shunt Stenosis Screening

Chen

Liu

et al. 2019

IEEE Access

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Clinically, arteriovenous shunt (AVS) stenosis results in turbulent and pulsatile flow because of high resistance and pressure within a narrowed space inside a stenotic access. Palpation and ultrasound methods are primarily used (first-line examination) to rapidly screen the risk of the degree of stenosis (DOS). Therefore, quantitative hemodynamic analysis involving Doppler ultrasound is performed in patients suffering from AVS stenosis and undergoing long-term hemodialysis. Doppler ultrasound with a center frequency of 7.5 MHz can provide substantial resolution and sensitivity to the measurement of blood flow velocity within a range of depth of 20.0-30.0 mm and a scan diameter of 10.0 mm. A hemodynamic method is used to analyze blood flow through a hemodialysis access in terms of dimensionless numbers. In this study, velocities were measured using Doppler ultrasound at three specific sites in vessels, namely, arterial anastomosis, loop, and venous anastomosis sites. Dimensionless numbers, such as supracritical Reynolds numbers, critical peak Reynolds numbers, and resistive indices, are determined in accordance with parallel conditional expressionbased rules to create decision trees for the rapid screening of the DOS at the abovementioned specific sites. For the enrolled subjects, results demonstrate that noninvasive hemodynamic analysis with Doppler ultrasound measurements and parallel decision trees has potential for the efficient screening of the DOS in patients suffering from AVS stenosis and undergoing long-term hemodialysis. Experimental results also indicate that the hit and true-positive rates of the proposed screening method in clinical indication are higher than those of the machine learning method.INDEX TERMS Doppler ultrasound, quantitative hemodynamic analysis, supracritical Reynolds number, resistive index, degree of stenosis.

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“…Progressive luminal narrowing of the radial artery has been reported following transradial procedures. Studies using intravascular ultrasound, optical coherence tomography, or histology have demonstrated alterations of the radial artery such as intimal damage, inflammation, and medial dissection after TRA coronary interventions 25–28. These endothelial changes may trigger a cascade of events promoting thrombus formation acutely as well as intimal hyperplasia with progressive narrowing over time.…”

Section: Discussionmentioning

confidence: 99%

Feasibility of repeat transradial access for neuroendovascular procedures

Chen

Brunet

Sur

et al. 2019

J NeuroIntervent Surg

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IntroductionTransradial artery access (TRA) for cerebrovascular angiography is increasing due to decreased access site complications and overwhelming patient preference. While interventional cardiologists have reported up to 10 successive TRA procedures via the same radial access site, this is the first study examining successive use of the same artery for repeat procedures in neurointerventional procedures.1 MethodsWe reviewed our prospective institutional database for all patients who underwent a transradial neurointerventional procedure between 2015 and 2019. Index procedures were defined as procedures performed via TRA after which there was a second TRA procedure attempted. Reasons for conversion to a transfemoral approach (TFA) for subsequent procedures were identified.Results104 patients underwent 237 procedures (230 TRA, 7 TFA). 97 patients underwent ≥2 TRA procedures, 20 patients >3, four patients >4, three patients >5, and two patients >6 TRA procedures. The success rate was 94.7% (126/133) with 52% (66/126) of successive procedures performed via the same radial access site (snuffbox vs antebrachial) while the alternate radial artery segment was used for access in 48% (60/126) of subsequent procedures. There were seven (5.3%) cases requiring crossover to TFA, six cases for radial artery occlusion (RAO) and one for radial artery narrowing.ConclusionSuccessive TRA is both technically feasible and safe for neuroendovascular procedures in up to six procedures. The low failure rate (5.3%) was primarily due to RAO. Thus, even without clinical consequences, strategies to minimize RAO should be optimized for patients to continue to benefit from TRA in future procedures.

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Distal radial arterial hypertrophy after transradial intervention: A serial intravascular ultrasound study

Abstract: Serial IVUS of the distal RA revealed a significant increase in IMV and decreases in LV and VV. Diabetes was the most powerful independent predictor of the percentage change in IMV of the distal RA after TRI. The percentage change in IMV was significantly positively correlated with HbA1c.

Cited by 8 publications

References 16 publications

Distal transradial access: a review of the feasibility and safety in cardiovascular angiography and intervention

Distal transradial access: a review of the feasibility and safety in cardiovascular angiography and intervention

Hemodynamic Quantitative Analysis Based on Doppler Ultrasound for Arteriovenous Shunt Stenosis Screening

Feasibility of repeat transradial access for neuroendovascular procedures

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