Hand ischemia after transradial coronary angiography: Resulting in right ring finger amputation

Ayan, Mohamed; Smer, Aiman; Azzouz, Muhammad Soubhi; Abu‐Zaid, Ahmed; Mooss, Aryan N.

doi:10.1016/j.carrev.2015.06.002

Cited by 18 publications

(11 citation statements)

References 13 publications

(15 reference statements)

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“…Thus, if the radial artery is occluded, blood supply of the hand can be maintained by the ulnar collateral circulation and RAO is a quiescent event. However, cases of hand ischemia after RAO have been described in the setting of inadequate collateral circulation (31)(32)(33). Some patients may experience pain at the site of the occlusion, paresthesias or reduced limb function (23).…”

Section: Radial Artery Occlusion (Rao)mentioning

confidence: 99%

Radial artery occlusion after transradial coronary catheterization

Avdikos

Karatasakis

Tsoumeleas

et al. 2017

Cardiovasc. Diagn. Ther.

114

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The transradial approach (TRA) for coronary angiography and interventions is increasingly utilized around the world. Radial artery occlusion (RAO) is the most common significant complication after transradial catheterization, with incidence varying between 1% and 10%. Although RAO is rarely accompanied by hand ischemia, it is an important complication because it prohibits future transradial access and radial artery utilization as a conduit for coronary artery bypass grafting or arteriovenous fistula formation. In this review, we discuss factors predicting the occurrence of RAO, aspects of accurate and prompt recognition, methods that contribute to its prevention and possible treatment options.

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Section: Radial Artery Occlusion (Rao)mentioning

confidence: 99%

Radial artery occlusion after transradial coronary catheterization

Avdikos

Karatasakis

Tsoumeleas

et al. 2017

Cardiovasc. Diagn. Ther.

114

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“…Complications such as arteriovenous fistulas (AV-fistula) and radial artery avulsion during sheath removal [14], as well as minor nerve damage and complex regional pain syndrome of the upper limb are rare [24], [25], [26]. A few instances of hand ischemia have been reported [16], [27], [28], [29].…”

Section: Introductionmentioning

confidence: 99%

Low rate of access site complications after transradial coronary catheterization: A prospective ultrasound study

Mattea

Salomon

Menck

et al. 2017

IJC Heart & Vasculature

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BackgroundTransradial artery (TRA) left heart catheterization is an increasingly used technique for both diagnostic and interventional coronary procedures. This study evaluates the incidence of access site complications in the current interventional era.Methods and resultsA total of 507 procedures were performed under standardized conditions. Each procedure was performed using high levels of anticoagulation, hydrophilic sheaths, and short post-procedural compression times. Vascular complications were assessed one day after TRA catheterization using Duplex sonography and classified according to the necessity of additional medical intervention. A simple questionnaire helped identifying upper extremity neurologic or motor complications. Vascular complications were detected in 12 patients (2.36%): radial artery occlusion was detected in 9 patients (1.77%), 1 patient developed an AV-fistula (0.19%), and 2 patients had pseudoaneurysms (0.38%). None of the patients required specialized medical or surgical intervention. Under our procedural conditions, small radial artery diameter was the only significant predictor for the development of post-procedural vascular complications (2.11 ± 0.42 mm vs 2.52 ± 0.39 mm, p = 0.001). None of the previously reported risk factors, namely, advanced renal failure, diabetes, acuteness/complexity of procedure, or sheath and catheter size significantly influenced the rate of vascular complications. No major hematoma or local neurologic or motor complications were identified.ConclusionsUsing current techniques and materials, we report a very low rate of local complications associated with TRA catheterization.

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“…Regarding the occurrence of RAO, its future use as an access site for CAG or PCI, a conduit for coronary bypass grafting, or for fistula formation in hemodialysis patients is limited. Additionally, RAO is associated with a potential risk of hand ischemia [ 10 , 11 ]. Kiemeneij first introduced the usefulness and safety of coronary catheterization via dTRA in 2017 [ 1 ], and yet, the occurrence of RAO after dTRA has never been reported to date [ 1 , 4 , 12 ].…”

Section: Discussionmentioning

confidence: 99%

A Comparative Analysis between Ultrasound-Guided and Conventional Distal Transradial Access for Coronary Angiography and Intervention

Mori

Hirano

Yamawaki

et al. 2020

Journal of Interventional Cardiology

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Objectives. To compare feasibility and safety between ultrasound-guided and conventional distal transradial access (dTRA). Background. Distal transradial access, a new technique for coronary angiography (CAG) and percutaneous coronary interventions (PCI), is safe and feasible and will become popular worldwide. Ultrasound-guided dTRA has been advocated to reduce failure rate and access-site complications. However, to date, the comparison of feasibility and safety between ultrasound-guided and conventional dTRA has not been reported. Method. Overall, 137 patients (144 procedures) who underwent CAG or PCI using dTRA between September 2018 and February 2019 were investigated. These patients were classified into two groups: C (dTRA with conventional punctures; 76 patients, 79 procedures) and U (dTRA with ultrasound-guided punctures; 61 patients, 65 procedures) groups. Successful procedural rate, procedural outcomes, and complication rate during hospital stays were compared between the two groups. Results. The procedural success rate was significantly higher in the U group than in the C group (97% vs. 87%, P=0.0384). However, the rate of PCI, puncture time, total fluoroscopy time, the volume of contrast medium, the rate of access-site ecchymosis, and incidence of nerve disorder were similar between the two groups. Additionally, radial artery occlusion after the procedure did not occur in this study. Conclusion. The ultrasound-guided dTRA for CAG or PCI was associated with a lower failure rate than conventional dTRA. However, there were no significant differences in puncture time and complication rate between the two procedures.

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Hand ischemia after transradial coronary angiography: Resulting in right ring finger amputation

Cited by 18 publications

References 13 publications

Radial artery occlusion after transradial coronary catheterization

Radial artery occlusion after transradial coronary catheterization

Low rate of access site complications after transradial coronary catheterization: A prospective ultrasound study

A Comparative Analysis between Ultrasound-Guided and Conventional Distal Transradial Access for Coronary Angiography and Intervention

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