Role of vascular ultrasound scanning in repeated trans‐radial coronary artery intervention (prospective randomized study)

Elmahdy, Mahmoud Farouk; Hammami, Mohamed; ElGuindy, Ahmed

doi:10.1002/ccd.27413

Cited by 4 publications

(3 citation statements)

References 30 publications

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“…This may not be enough. The results of the present article of Elmahdy, et al, suggest perhaps another target for continuous improvement programs. A new metric to consider may be the state of radial arteries in their chronic state after radial artery procedures when these patients return for repeat procedures.…”

mentioning

confidence: 48%

“…Percutaneous transradial cardiac catheterization has been around for almost 30 years, and techniques to improve access have continued to evolve. In this issue of the Journal, Elmahdy et al have published their experience with ultrasound to facilitate access in patients with prior radial access. The active arm of this study used ultrasound, not to augment access directly to the radial artery, but rather as a pre‐procedure triage tool to identify radial arteries that showed signs of vessel wall thickening or vascular stenosis that might signify a damaged artery.…”

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confidence: 99%

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Residual damage in previously instrumented radial arteries

Mazur

Gilchrist

2018

Cathet Cardio Intervent

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Key Points Pre‐procedural radial artery ultrasound may reduce both vascular access time and total procedure time in patients who previously had radial artery procedures. Many radial arteries that were previously instrumented appear to have chronic changes that may make them unfavorable for future use. Attention to best practice for radial artery catheterization and measurements of long‐term radial artery damage may be important metrics for sustainable, long‐term use of transradial access.

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confidence: 48%

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confidence: 99%

Residual damage in previously instrumented radial arteries

Mazur

Gilchrist

2018

Cathet Cardio Intervent

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“…Repeated ipsilateral radial artery access might aggravate damage to the radial intima, which might decrease the successful puncture rate and increase the incidence of access-related complications, including RAO [11,12]. To date, most randomized studies comparing the effects of dTRA and TRA on the incidence of RAO have included some patients with a history of ipsilateral radial artery intervention, which might have an impact on the incidence of RAO.…”

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confidence: 99%

Comparison of long-term radial artery occlusion via distal vs. conventional transradial access (CONDITION): a randomized controlled trial

Chen,

Li,

et al. 2024

BMC Med

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Background The distal transradial access (dTRA) has become an attractive and alternative access to the conventional transradial access (TRA) for cardiovascular interventional diagnosis and/or treatment. There was a lack of randomized clinical trials to evaluate the effect of the dTRA on the long-term radial artery occlusion (RAO). Methods This was a prospective, randomized controlled study. The primary endpoint was the incidence of long-term RAO at 3 months after discharge. The secondary endpoints included the successful puncture rate, puncture time, and other access-related complications. Results The incidence of long-term RAO was 0.8% (3/361) for dTRA and 3.3% (12/365) for TRA (risk ratio = 0.25, 95% confidence interval = 0.07–0.88, P = 0.02). The incidence of RAO at 24 h was significantly lower in the dTRA group than in the TRA group (2.5% vs. 6.7%, P < 0.01). The puncture success rate (96.0% vs. 98.5%, P = 0.03) and single puncture attempt (70.9% vs. 83.9%, P < 0.01) were significantly lower in the dTRA group than in the TRA group. However, the number of puncture attempts and puncture time were higher in the dTRA group. The dTRA group had a lower incidence of bleeding than the TRA group (1.5% vs. 6.0%, P < 0.01). There was no difference in the success rate of the procedure, total fluoroscopy time, or incidence of other access-related complications between the two groups. In the per-protocol analysis, the incidence of mEASY type ≥ II haematoma was significantly lower in the dTRA group, which was consistent with that in the as-treated analysis. Conclusions The dTRA significantly reduced the incidence of long-term RAO, bleeding or haematoma. Trial registration ClinicalTrials.gov identifer: NCT05253820.

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