Effectiveness of enoxaparin for prevention of radial artery occlusion after transradial cardiac catheterization

Feray, Hasan; İzgi, Cemil; Cetiner, Diler; Men, Ebubekir Emre; Saltan, Yelda; Baltay, Ayhan; Kahraman, Reyhan

doi:10.1007/s11239-009-0352-0

Cited by 27 publications

(9 citation statements)

References 12 publications

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“…Lower body weight, lower systolic blood pressure at haemostasis and the presence of local haematoma and discomfort after the procedure are more frequent findings in radial occlusion 108 . To prevent occlusion, anticoagulation is necessary during the procedure with intravenous unfractionated heparin (UH) 56 or other more costly anticoagulant strategies [113][114][115][116] . Better patency rates are obtained using smaller catheters 115 and careful radial haemostasis techniques, with non-occlusive radial artery compression ideally removed within two hours 5!,118,119 .…”

Section: Complications: Prevention and Managementmentioning

confidence: 99%

Consensus document on the radial approach in percutaneous cardiovascular interventions: position paper by the European Association of Percutaneous Cardiovascular Interventions and Working Groups on Acute Cardiac Care** and Thrombosis of the European Society of Cardiology

Hamon

Pristipino²,

Mario³

et al. 2013

EuroIntervention

362

239

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Radial access use has been growing steadily but, despite encouraging results, still varies greatly among operators, hospitals, countries and continents. Twenty years from its introduction, it was felt that the time had come to develop a common evidence-based view on the technical, clinical and organisational implications of using the radial approach for coronary angiography and interventions. The European Association of Percutaneous Cardiovascular Interventions (EAPCI) has, therefore, appointed a core group of European and non-European experts, including pioneers of radial angioplasty and operators with different practices in vascular access supported by experts nominated by the Working Groups on Acute Cardiac Care and Thrombosis of the European Society of Cardiology (ESC). Their goal was to define the role of the radial approach in modern interventional practice and give advice on technique, training needs, and optimal clinical indications.

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Section: Complications: Prevention and Managementmentioning

confidence: 99%

Consensus document on the radial approach in percutaneous cardiovascular interventions: position paper by the European Association of Percutaneous Cardiovascular Interventions and Working Groups on Acute Cardiac Care** and Thrombosis of the European Society of Cardiology

Hamon

Pristipino²,

Mario³

et al. 2013

EuroIntervention

362

239

View full text Add to dashboard Cite

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“…Even patients with normal palmar collateral circulation tests before the transradial procedure can encounter severe ischemic symptoms that warrant treatment. Many physicians apply temporary occlusion of the ulnar artery and anticoagulation in the form of low molecular weight heparin or intravenous heparin injections for recanalization 1 , 11 , 20 , 21 , 36 ). While operative treatment may be required for some patients, RAO is usually asymptomatic.…”

Section: Discussionmentioning

confidence: 99%

“…RAO can preclude radial artery use for access and as a donor for future bypass surgery. The rate of RAO varies from 5% to 30% depending on the tool used for diagnosis, with ultrasound being the most accurate 4 , 11 , 21 , 23 , 26 , 28 - 30 , 36 ). In a large prospective study, Uhlemann et al 30 ) described the advantage of ultrasonography for the investigation of local complications in patients who underwent transradial PCI.…”

Section: Discussionmentioning

confidence: 99%

Complications Following Transradial Cerebral Angiography : An Ultrasound Follow-Up Study

Yoon

Kwon

Choudhri

et al. 2018

J Korean Neurosurg Soc

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ObjectiveThe feasibility and usefulness of transradial catheterization for coronary and neuro-intervention are well known. However, the anatomical change in the catheterized radial artery (RA) is not well understood. Herein, we present the results of ultrasonographic observation of the RA after routine transradial cerebral angiography (TRCA). MethodsPatients who underwent routine TRCA with pre- and post-procedure Doppler ultrasonography (DUS) of the catheterized RA were enrolled. We then recorded and retrospectively reviewed the diameter and any complicated features of the RA observed on DUS, and the factors associated with the diameter and complications were analyzed. ResultsA total of 223 TRCAs across 181 patients were enrolled in the current study. The mean RA diameter was 2.48 mm and was positively correlated with male gender (p<0.001) and hypertension (p<0.002). The median change in diameter after TRCA was less than 0.1 mm (range, -1.3 to 1.2 mm) and 90% of changes were between -0.8 and +0.7 mm. Across 228 procedures, there were 12 cases (5.3%) of intimal hyperplasia and 22 cases (9.6%) of asymptomatic local vascular complications found on DUS. Patients with abnormal findings on the first procedure had a smaller pre-procedural RA diameter than that of patients without findings (2.26 vs. 2.53 mm, p=0.0028). There was no significant difference in the incidence of abnormal findings for the first versus subsequent procedures (p=0.68). ConclusionDUS identified the pre- and post-procedural diameter and local complications of RA. Routine TRCA seems to be acceptable with regard to identifying local complications and changes in RA diameter.

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“…In a study with a group of 39 patients the effect of 60 mg enoxaparin, given to the radial artery sheath, on the occurrence of RAO was evaluated. The incidence of RAO assessed at discharge was low and was 4% [75]. The use of bivalirudin in the prevention of RAO has also been reported.…”

Section: Anticoagulationmentioning

confidence: 99%

Expert reviews Radial artery occlusion after percutaneous coronary interventions – an underestimated issue

Sławin¹,

Kübler²,

Szczepański³

et al. 2013

pwki

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The femoral approach is the most common arterial access for percutaneous coronary artery interventions. Despite the convenience and simplicity of this approach, it is burdened with a high risk of arterial puncture bleeding, which worsens the prognosis of the patient. An alternative approach through the radial artery has been gaining more and more popularity in recent years. This is due to a significant reduction of local bleeding complications as compared with the femoral artery approach. The use of the radial approach in patients with ST-segment elevation myocardial infarction improves outcome, reducing the risk of death, subsequent myocardial infarction and stroke, and is the preferred approach according to the latest ESC guidelines. In addition to improving safety, it is beneficial for improving patient comfort, with a shorter recovery after the procedure, shorter hospitalization and lower medical costs. One of the major complications of procedures performed through the radial approach is radial artery occlusion (RAO). Although it usually has an asymptomatic course, RAO eliminates the ability to use the radial artery as an access in the future. A number of factors that contribute to the occurrence of RAO have been identified, such as the size of the sheath and the catheter, diameter ratio of the sheath to the diameter of the radial artery, insufficient anticoagulation and, above all, the way of obtaining hemostasis at the puncture site: the duration of artery compression after sheath removal and the preservation of artery patency during compression (so-called patent hemostasis). This paper presents the current state of the art about the factors that contribute to the occurrence of RAO and methods for preventing this complication.

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Effectiveness of enoxaparin for prevention of radial artery occlusion after transradial cardiac catheterization

Cited by 27 publications

References 12 publications

Consensus document on the radial approach in percutaneous cardiovascular interventions: position paper by the European Association of Percutaneous Cardiovascular Interventions and Working Groups on Acute Cardiac Care** and Thrombosis of the European Society of Cardiology

Consensus document on the radial approach in percutaneous cardiovascular interventions: position paper by the European Association of Percutaneous Cardiovascular Interventions and Working Groups on Acute Cardiac Care** and Thrombosis of the European Society of Cardiology

Complications Following Transradial Cerebral Angiography : An Ultrasound Follow-Up Study

Expert reviews Radial artery occlusion after percutaneous coronary interventions – an underestimated issue

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