Radial Artery Ultrasound Predicts the Success of Transradial Coronary Angiography

Abazid, Rami M.; Bashir, Yaser; Mohamed, Mohamed Z.; Smettei, Osama A.; Kattea, M. Obadah; Suresh, Annie; Saker, Haitham

doi:10.1016/s0735-1097(16)30078-x

Cited by 3 publications

(3 citation statements)

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“…The RA is a small-sized artery whose diameter ranges from 1.15 to 3.95 mm (8). Smaller RADs have been associated with vascular complications (9,10). Multiple puncture attempts increase the risk of vasospasm and may result in hemorrhage, dissection, pseudoaneurysm, thrombosis and pain.…”

Section: Introductionmentioning

confidence: 99%

Effect of transient ulnar artery compression on radial artery diameter

Yılmaztepe

Yılmaz

2018

Exp Ther Med

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The transradial approach is widely preferred in coronary procedures. A small radial artery diameter (RAD) is the most important factor affecting successful access. Various maneuvers and medications have been used to increase the RAD and thereby facilitate RA cannulation. Ulnar artery compression (UAC) for 30 min has been indicated to be effective in increasing the RAD and facilitating RA access. The aim of the present preliminary study was to assess the effect of transient UAC for 1 min on the RAD. A total of 151 patients were included in the present study. RA ultrasonography was performed at the level of the wrist. The UA was compressed for 1 min. The RAD was measured at baseline, at the end of UAC and at 1 min thereafter. The results indicated that the RAD was significantly smaller in diabetic vs. non-diabetic patients (2.35±0.43 vs. 2.50±0.39 mm, P=0.024) and in women vs. men (2.25±0.38 vs. 2.56±0.38 mm, P<0.001). At the end of UAC, the RAD was increased compared with that at baseline (2.45±0.41 vs. 2.62±0.41 mm, P<0.001), but it started to decrease thereafter, and the RAD measured at 1 min after stopping UAC was significantly smaller (2.62±0.41 vs. 2.55±0.40 mm, P<0.001), while remaining significantly larger than that at baseline (P<0.001). The RA peak systolic flow velocity also increased significantly during UAC (35.3±8.9 vs. 60.3±19.2 cm/sec; P<0.001). In conclusion, Transient UAC for 1 min significantly increased the RAD and the peak systolic flow velocity. Further studies with clinical endpoints are required for further exploration of the feasibility of this approach.

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Section: Introductionmentioning

confidence: 99%

Effect of transient ulnar artery compression on radial artery diameter

Yılmaztepe

Yılmaz

2018

Exp Ther Med

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“…In another randomized controlled trial performed in Australia that enrolled 1388 patients, ultrasound use decreased time to getting access (93 vs. 11 seconds, p = 0.009), the number of attempts (1.47 vs. 1.9, p < 0.0001) with increased chances of success from the first try (73% vs. 59.7%, p < 0.0001) [16]. Besides the faster and higher success rate, pre-puncture ultrasound can prevent vascular complications by properly sizing the radial artery to sheath diameter [17].…”

Section: Ultrasound Accessmentioning

confidence: 99%

Radial Artery Access

Panetta¹,

Chahine²

2021

Interventional Treatment for Structural Heart Disease

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Radial artery access for angiography has matured over the past two decades and is now the preferred point of access for most patients. Lower bleeding rates in clinical randomized trials have translated into lower mortality prompting change in the guidelines. Advances in technique with use of ultrasound for access to properly size the sheath, proper dosing of anticoagulation and new techniques for sheath removal have dramatically lowered radial artery occlusion rates. Radial artery spasm has improved with vasodilators and proper sedation. Advances in support boards and sheath extension have opened up left radial access. Advances in lower profile sheaths and sheathless systems allow larger catheters in smaller arteries. Advances in longer balloons and sheaths have opened up radial access for peripheral interventions. Areas of clinical research include use of ulnar artery compared to radial, left versus right radial access, use of radial artery for a surgical conduit after angiography, radiation exposure and advantage of radial approach in the elderly.

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“…The use of ultrasound has been widely incorporated into most cath labs to assist with vascular access. Studies have found that the use of ultrasound during radial artery access can help predict the success of TRA coronary angiography [14]. However, even with the wide utilization of ultrasound for firstattempt radial access, TRA failure requiring crossover to another vascular site has remained a limitation of the radial approach [15].…”

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confidence: 99%

A Simple Tool to Predict Transradial Access Fai lure for Coronary Angiography

2021

Journal of Clinical Cardiology

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CHA 2 DS 2 -VASc score of 8 or higher [4].We believe that the CHA 2 DS 2 -VASc score can be used by cardiologists as a simple tool to predict TRA failure. By calculating a CHA 2 DS 2 -VASc score, physicians can easily and quickly determine which patients are at risk for TRA failure and proceed with a femoral approach in those with a high score. This simple scoring system will not only save time in emergent situations but also eliminate the potential complications of attempting and failing the radial approach. While our study demonstrated promising results and supports the use of the CHA 2 DS 2 -VASc score to predict TRA failure, more studies are needed to fully assess its use in the cath lab.

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Radial Artery Ultrasound Predicts the Success of Transradial Coronary Angiography

Cited by 3 publications

References 0 publications

Effect of transient ulnar artery compression on radial artery diameter

Effect of transient ulnar artery compression on radial artery diameter

Radial Artery Access

A Simple Tool to Predict Transradial Access Fai lure for Coronary Angiography

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