Safety and efficacy of repeat transradial access for cardiac catheterization procedures

Caputo, Ronald P.; Simons, Alan; Giambartolomei, Alessandro; Grant, William D.; Fedele, Kathleen; Abraham, Sunil; Felice, Peter A.; Reger, Mark J.; Walford, Gary; Esente, Paolo

doi:10.1002/ccd.1264

Cited by 20 publications

(11 citation statements)

References 12 publications

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“…Radial access has been shown to be useful in fully anticoagulated patients [20] and it is also safe to use in repeated procedures [21]. One drawback of radial access is that it is more difficult to perform than femoral access with a long learning curve.…”

Section: Discussionmentioning

confidence: 99%

Radiation exposure and patient experience during percutaneous coronary intervention using radial and femoral artery access

Geijer

Persliden

2004

Eur Radiol

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The aim of this study was to evaluate radiation dose and patient discomfort/pain in radial artery access vs femoral artery access in percutaneous coronary intervention (PCI). Dose-area product (DAP) was measured non-randomised for 114 procedures using femoral access and for 55 using radial access. The patients also responded to a questionnaire concerning discomfort and pain during and after the procedure. The mean DAP was 69.8 Gy cm(2) using femoral access and 70.5 Gy cm(2) using radial access. Separating the access site from confounding factors with a multiple regression, there was a 13% reduction in DAP when using radial access (p=0.038). Procedure times did not differ (p=0.81). Bed confinement was much longer in the femoral access group (448 vs 76 min, p=0.000). With femoral access, there was a significantly higher patient grading for chest (p=0.001) and back pain (p=0.003) during the procedure and for access site (p=0.000) and back pain (p=0.000) after the procedure. Thirty-two femoral access patients (28%) were given morphine-type analgesics in the post-procedure period compared to three radial access patients (5%, p=0.001). DAP does not increase when using radial instead of femoral access and the patients grade discomfort and pain much lower when using radial access. Radial access is thus beneficial to use.

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Section: Discussionmentioning

confidence: 99%

Radiation exposure and patient experience during percutaneous coronary intervention using radial and femoral artery access

Geijer

Persliden

2004

Eur Radiol

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“…[11][12][13][14][15] However, the routine use of the radial artery as an access site for cardiac catheterization has prompted questions about the feasibility, efficacy, and safety of repeated transradial procedures. [16][17][18][19] Authors have suggested that routine use of the radial artery might lead to a relatively frequent occurrence of arterial occlusion, limiting this vessel's viability as an access site for repeated procedures. [20][21][22][23] In 2006, our institution adopted radial access as the preferred route for elective, urgent, and emergency catheterization procedures.…”

mentioning

confidence: 99%

Repeated Transradial Catheterization: Feasibility, Efficacy, and Safety

Charalambous¹,

Constantinides²,

Talias³

et al. 2014

Texas Heart Institute Journal

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“…11 Worldwide there has been a lot of studies of spasmolytics which has shown the benefit. 4,5,6,9,11,12,13,14 Among these studies it has been recommended by Kiemeneij et al 11 that the spasm is significantly reduced by 34-14% by the use of cocktail with intra-arterial nitroglycerin and verapamil. Radial access for coronary intervention has been in practice in Nepal for last several years there has been no study regarding the different vasodilator regimen for the prevention of radial artery spasm during the procedure.…”

Section: *Corresponding Authormentioning

confidence: 99%

“…1,2,3 Previous studies have shown that transradial artery approach for coronary artery catheterization and intervention to be safe, easy and effective, as well as cost effective. 4 Patients also prefer transradial route in comparison to the femoral access because of lower incidence of back and access site pain and earlier ambulation. 5,6 The advantages we get from the radial route has some demerits also and it…”

Section: Introductionmentioning

confidence: 99%

Comparision of Various Vasodilators Regimen During Radial Corornary Angiogram: A Prospective Randomised Trial

Malla

Adhikari

et al. 2017

J Adv Intern Med

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Background and Aims: Coronary intervention through radial artery is a preferred over femoral route. Different vasodilators are used to prevent radial artery spasm. Till date there is no study to compare the effects of various vasodilator regimes during radial coronary angiogram in Nepal. We aim to compare the efficacy of different vasodilator in our patients.Methods and Result: This is a single centre, prospective randomized trial between Verapamil, Nitroglycerine (GTN) and cocktail (Verapamil with GTN). All the patient undergoing coronary angiogram via radial approach, without the contraindication were randomized by a computer generated randomization protocol. Patient undergoing coronary procedures via the radial artery were divided into three groups. Patients in group A received intra-arterial cocktail (2.5 mg of Verapamil plus 100 mcg Nitroglycerine in 10 ml of normal saline), patients in group B received Verapamil (5mg) and patient in group C received Nitroglycerine (200mcg). Heparin of 3000U was given intravenously in all three groips. Altogether 207 patients underwent transradial coronary angiogram, 203 were randomized after exclusion. Over all Radial artery spasm was reported in 28 patients (13.79%). There was no statistically significant difference in spasm between the three regimens however when grading, there was significant higher grade of spasm in Verapamil group (13.23%, P value < 0.05). When comparing Verapamil and GTN separately there was significant higher spasm (21% vs 7%, P value < 0.05) with higher grades of spasm in verapamil group.Journal of Advances in Internal Medicine 2016;05(01):11-14

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Safety and efficacy of repeat transradial access for cardiac catheterization procedures

Cited by 20 publications

References 12 publications

Radiation exposure and patient experience during percutaneous coronary intervention using radial and femoral artery access

Radiation exposure and patient experience during percutaneous coronary intervention using radial and femoral artery access

Repeated Transradial Catheterization: Feasibility, Efficacy, and Safety

Comparision of Various Vasodilators Regimen During Radial Corornary Angiogram: A Prospective Randomised Trial

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