Retrograde subintimal recanalization of a radial artery occlusion after coronary angiography using the palmar loop technique

Ruzsa, Zoltán; Kovács, Nándor; Merkely, Béla

doi:10.1016/j.carrev.2014.12.002

Cited by 14 publications

(13 citation statements)

References 11 publications

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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%

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Radial artery occlusion after transradial coronary catheterization

Avdikos

Karatasakis

Tsoumeleas

et al. 2017

Cardiovasc. Diagn. Ther.

115

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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%

“…Percutaneous techniques have also been used to treat RAO. Recanalization of the occluded radial artery with angioplasty has been described in a number of studies (28,29,32). The occluded part can be approached from the distal radial artery, the palmar arch or antegradely from the brachial artery.…”

Section: Treatment Of Raomentioning

confidence: 99%

Radial artery occlusion after transradial coronary catheterization

Avdikos

Karatasakis

Tsoumeleas

et al. 2017

Cardiovasc. Diagn. Ther.

115

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“…When symptomatic RAO was accompanied by CHI, conservative treatment is not adequate, and invasive treatment with angioplasty should be considered. The data in the literature are very limited regarding long‐term results in this patient subgroup, and only case reports exist . Our patient group consisted of 15 symptomatic patients after transradial angioplasty; all had rest pain and one patient also had a digital ulcer.…”

Section: Discussionmentioning

confidence: 99%

“…Dual access site was obtained in failed anterograde cases, using the distal radial (snuffbox segment) or ulnar artery (UA) when the anterograde recanalization failed. In some cases, the palmar arch technique was used as a retrograde technique …”

Section: Methodsmentioning

confidence: 99%

“…CHI is either acute (aCHI) or chronic (cCHI), determined by characteristics of disease onset. In the literature, only case reports and a limited number of studies about interventional treatment can be found . The aim of this prospective study was to assess the long‐term feasibility, safety, and outcomes of percutaneous transluminal angioplasty (PTA) and catheter‐directed thrombolysis in the treatment of CHI.…”

Section: Introductionmentioning

confidence: 99%

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Short‐ and long‐term results with a percutaneous treatment in critical hand ischaemia

Ruzsa

Berta

Tóth

et al. 2019

Cathet Cardio Intervent

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Background The aim of this prospective registry was to determine the feasibility, safety, and outcomes of percutaneous transluminal angioplasty and thrombolysis in the treatment of critical hand ischemia (CHI). Methods One‐hundred one patients (aged 60.6 ± 15.3 years) were treated for CHI between 2012 and 2016 in three cardiovascular centers. Anatomically, the upper arm was divided into three segments (I‐subclavian, II‐brachial, and III‐forearm). We examined the rates of technical and clinical success, major adverse events (MAEs), and vascular complications at 1 year and at long‐term follow‐up. Results Nineteen patients (18.8%) were treated for acute CHI, and 82 (81.2%) for chronic CHI. Median follow‐up was 36.9 (19.6–68.3) months. Clinical symptoms were isolated rest pain in 91 patients (90.1%) and digital ulcer or gangrene in 10 patients (9.9%). The technical and clinical success rate of intervention was 96.0% (97/101) and 84.2% (85/101) at 1 year. Angioplasty was performed in Segments I, II, and III in 28 (27.7%), in 29 (28.7%), and 44 (43.5%) patients. Stent implantation was necessary in 47 patients (46.8%). Vascular access site complications were found in 2.1% of the sample. After 1 year, MAEs occurred in 27 patients (26.9%), and the target lesion revascularization rate was 11.9%. In two patients (1.9%), thoracic sympatectomy was necessary, and two patients (1.9%) underwent minor finger amputations. Conclusions Angioplasty of hand vessels for CHI is a feasible and safe procedure with acceptable rates of technical success and hand healing. MAEs are frequent because the rate of severe comorbidities is high.

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Transradial and transulnar access for iliac artery interventions using sheathless guiding systems: A feasibility study

Ruzsa

Tóth

Nemes

et al. 2016

Cathet Cardio Intervent

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PurposeOur aim was to evaluate the acute success and complication rates of the transradial and transulnar access for iliac artery stenting using sheathless guiding systems.MethodsClinical and angiographic data from 156 consecutive patients with symptomatic iliac artery stenosis who were treated with transradial or transulnar access were evaluated. All patients underwent Duplex ultrasound before and after the intervention. The primary endpoints were the procedural success rate, major adverse events, and access site complication rates. The secondary endpoints were the angiographic result of the iliac artery intervention, fluoroscopy time, X‐ray dose, procedure length, crossover rate to another puncture site and hospitalization duration. The impact of the learning curve was also investigated, along with right or left radial access.ResultsThe indication for the intervention was intermittent claudication in 109 patients (69.9%), critical limb ischemia in 44 (28.2%) subjects and acute limb ischemia in three individuals (1.9%). Technical success was achieved in 155 patients (99.4%), with a crossover rate of 3.8%. Radial and ulnar artery access was used in 151 (96.8%) and 7 (4.5%) patients, respectively. The Ankle‐brachial index increased from 0.69 [0.65–0.72] to 0.91 [0.88–0.95] as a result of the procedures (P < 0.001). The cumulative incidence of major adverse events was 3.8% at the 2‐month follow‐up (0% in patients with intermittent claudication and 13.8% in patients with critical limb ischemia). Radial artery access site complications were encountered in eight patients (5.1%). We documented decreased X‐ray doses (1742.0 [783.9–2701] vs. 1435 [991.1–1879] vs. 692.8 [275.3–1110] Gy cm−2 P < 0.05) over time; however, the fluoroscopy time, procedure time, and contrast consumption were not significantly different. Left hand access was not associated with significantly better results than right radial artery access.ConclusionsIliac artery stenting can be safely and effectively performed using radial or ulnar artery access and sheathless guiding catheters, with acceptable complication rates and high levels of technical success. The physician learning curve plays an important role in decreasing the X‐ray dose. © 2016 The Authors. Catheterization and Cardiovascular Interventions Published by Wiley Periodicals, Inc.

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Retrograde subintimal recanalization of a radial artery occlusion after coronary angiography using the palmar loop technique

Cited by 14 publications

References 11 publications

Radial artery occlusion after transradial coronary catheterization

Radial artery occlusion after transradial coronary catheterization

Short‐ and long‐term results with a percutaneous treatment in critical hand ischaemia

Transradial and transulnar access for iliac artery interventions using sheathless guiding systems: A feasibility study

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