Impact of sheath size and hemostasis time on radial artery patency after transradial coronary angiography and intervention in Japanese and non‐Japanese patients: A substudy from RAP and BEAT (Radial Artery Patency and Bleeding, Efficacy, Adverse evenT) randomized multicenter trial

Aminian, Adel; Saïto, Shigeru; Takahashi, Akihiko; Bernát, Ivo; Jobe, Robert; Kajiya, Takashi; Gilchrist, Ian C.; Louvard, Yves; Kiemeneij, Ferdinand; Royen, Niels van; Leeuwen, Maarten van; Yamazaki, Seiji; Matsukage, Takashi; Iglesias, Juan F.; Rao, Sunil V.

doi:10.1002/ccd.27526

Cited by 46 publications

(25 citation statements)

References 18 publications

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“…To this regard, our finding that longer TR-band time was significantly associated with RAO is worth noting. In fact, this finding is in line with previous studies [ 31 , 32 , 33 , 34 ]. Interestingly, Lavi et al reported that shortening the haemostasis time to one hour is able to further reduce RAO incidence [ 35 ].…”

Section: Discussionsupporting

confidence: 93%

Hand Laser Perfusion Imaging to Assess Radial Artery Patency: A Pilot Study

Indolfi

Passafaro

Sorrentino

et al. 2018

JCM

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Objectives: To test a novel diagnostic technique to assess radial artery perfusion after transradial catheterization. Background: Despite being mostly asymptomatic, radial artery occlusion (RAO) is not a benign complication, and its diagnosis is frequently missed because it requires time-consuming diagnostic testing. We developed a novel operator-independent diagnostic test to assess RAO after coronary procedures through a transradial access (TRA) by means of hand Laser Perfusion Imaging (LPI). Methods: One hundred patients were evaluated before and after TRA by means of the LPI. A radial perfusion index (RPI) was calculated as the ratio between the total perfusion measured during ulnar occlusion and total basal perfusion. Vascular Duplex scan (VDS) was used as the standard of reference to assess the artery patency. Results: LPI correctly identified RAO in 100% of cases. Post-procedural RPI was 0.89 ± 0.13 in patients with radial patency vs. 0.15 ± 0.04 in patients with RAO (p < 0.001). In line with these results, ROC analysis showed an excellent diagnostic performance of the LPI, that correctly identified all RAO cases (Area Under the Curve, AUC = 1.0; p < 0.001), with an optimal diagnostic cutoff at 0.2 RPI. Conclusions: LPI is a reliable diagnostic technique for RAO, offering the advantages of being quick and simple to perform.

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Section: Discussionsupporting

confidence: 93%

Hand Laser Perfusion Imaging to Assess Radial Artery Patency: A Pilot Study

Indolfi

Passafaro

Sorrentino

et al. 2018

JCM

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“…Procedure related parameters include recurring failed attempts of radial punctures, lack of aspirin pre-treatment, increased sheath-to-artery ratio and lack of periprocedural intravascular anticoagulation 10,[11][12][13] . Post-procedural risk factors specifically include non patenthemostasis 5,14,15 and prolonged time for hemostasis [16][17][18][19] . Anticoagulation during procedure is crucial to prevent RAO because thrombus formation is central factor leading to occlusion of radial artery.…”

Section: Discussionmentioning

confidence: 99%

Comparison of Intravenous Versus Intr-Arterial Heparin for the Prevention of Radial Artery Occlusion During Transradial Coronary Artery Cathetherization

Khalid

Mohsin

Halim

et al. 2021

PAFMJ

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Objective: To determine the relative efficacy of intravenous heparin as compared to intra-arterial heparin used during transradial coronary angiography for the prevention of radial artery occlusion. Study Design: Comparative cross-sectional study. Place and Duration of Study: Study was conducted at the Department of Cardiology, AFIC/NIHD Rawalpindi, Pakistan, from Jul 2019 to Dec 2019. Methodology: A total number of 144 patients were considered for the study using the consecutive sampling technique who were undergoing diagnostic coronary angiography. Patients were divided into the intra-arterial group (n=72) who received 50 IU/kg of unfractionated heparin (maximal dose 5,000 U) intra-arterially, and an intravenous group (n=72) received the similar dose through intravenous route. All patients were administered 100 mcg of nitroglycerin to minimize radial artery spasm. Coronary Angiography was performedusing a 6F introducer sheath and diagnostic catheters. Early radial artery occlusion (RAO) at 24 hours after the procedure was detected by performing the plethysmographic (reverse Barbeau’s) and doppler USG evaluation. Chronic RAO was assessed 30 days after the procedure by performing the same tests. Data was collected through a predesigned proforma and analyzed using SPSS 23. A p-value of less than 0.05 was considered as significant. Results: Early RAO was found in 4 (5.6%) of the patients from the intra-arterial groupand 5 (6.9%) of the intravenous group. The difference was found to be statistically insignificant (p-value 0.731). Chronic RAO was observed in 3 (4.4%) of the intra-arterial group as compared to 4 (6%) of the intravenous group. This difference was also statistically insignificant (p-value 0.683) for chronic RAO. Conclusion: Intra-arterial and intravenous heparin administration providedsimilar efficacy to prevent RAO.

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“…However, there is no consensus on the duration of compression needed, with practices ranging from as few as 60 min to as long as 6 hr as practiced in Japan. Longer compression time is associated with increased RAO occlusion rates and likely greater observation costs, while <60 min of compression has been associated with increased hematoma rates …”

Section: Radial Hemostasis Optionsmentioning

confidence: 99%