Vascular Complications Following Transradial and Transulnar Coronary Angiography in 1600 Consecutive Patients

Hahalis, George; Kakkos, Stavros K.; Panagopoulos, Andreas; Tsota, Irene; Davlouros, Periklis; Xanthopoulou, Ioanna; Koniari, Ioanna; Grapsas, Nikos; Christodoulou, Ioannis; Almpanis, George; Leopoulou, Marianna; Kounis, Nicholas G.; Alexopoulos, Dimitrios

doi:10.1177/0003319715592095

Cited by 25 publications

(19 citation statements)

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“…, Panels D–F). As it has been reported, incidence of compartment syndrome is a very low following transradial coronary intervention . To our knowledge, this is the first case report of severe dorsal hand laceration secondary to compartment syndrome.…”

supporting

confidence: 49%

“…As it has been reported, incidence of compartment syndrome is a very low following transradial coronary intervention. 1,2 To our knowledge, this is the first case report of severe dorsal hand laceration secondary to compartment syndrome. A high suspicion with any complaint of pain and swelling in the forearm and a proper management of hemostasis with great emphasis in high-risk population, especially elderly, female patients with low body surface area are the key points.…”

mentioning

confidence: 80%

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Severe Dorsal Hand Laceration Secondary to Compartment Syndrome Following Transradial Coronary Intervention

Song

Yang

Zhou

2015

J Interven Cardiology

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supporting

confidence: 49%

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confidence: 80%

Severe Dorsal Hand Laceration Secondary to Compartment Syndrome Following Transradial Coronary Intervention

Song

Yang

Zhou

2015

J Interven Cardiology

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“…Moreover, the radial approach is also associated with more comfort for the patient, shorter hospitalization stays, and lower costs of treatment. However, RAO is one of the major complications of procedures performed via the radial artery [17,18]. Although with an asymptomatic course, as well as the incidence of hand ischemia caused by RAO is extremely rare, RAO eliminates the ability to use the radial artery as an access for PCI in the future, to use it as a bypass conduit for patients undergoing coronary artery bypass surgery, or to use it for dialysis fistula.…”

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confidence: 99%

Comparison of long-term radial artery occlusion following trans-radial coronary intervention using 6-french versus 7-french sheaths

et al. 2021

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Background: The aim of this study was to explore the impact of 6-Fr and 7-Fr sheaths on the incidence of long-term radial artery occlusion (RAO) after trans-radial coronary intervention (TRI). , patients with ischemic heart disease including acute myocardial infarction and true bifurcation lesions were randomly assigned to 6-Fr group and 7-Fr group immediately after coronary angiography in a 1:1 ratio. The radial artery diameters were observed by ultrasound examination one day prior to TRI as well as at 30 days and 1 year after TRI. The primary endpoint was the incidence of RAO at 1-year after TRI. The secondary endpoints were the incidence of local vascular complications during hospitalization and changes of radial artery diameters within 1-year after TRI between the two groups. Additionally, multivariate logistic regression analysis was used to explore potential factors related to the incidence of long-term RAO after TRI. Results: A total of 214 patients were enrolled and randomly assigned to 6-Fr group (n = 105) or 7-Fr group (n = 109). There was no significant difference in the incidence of RAO at 1-year after TRI (8.57% vs. 12.84%, p = 0.313). Moreover, no significant difference was observed in the incidence of local vascular complications during hospitalization (20% vs. 24.77%, p = 0.403). After 1-year follow-up, no significant difference was found in radial artery diameters (2.63 ± 0.31 mm vs. 2.64 ± 0.27 mm, p = 0.802). Multivariate logistic analysis revealed that repeated TRI was an independent risk factor of long-term RAO 1 year after TRI (OR = 10.316,, p = 0.001). Conclusions: Compared to 6-Fr sheath, 7-Fr sheath did not increase short-term or long-term incidence of RAO after TRI. (Cardiol J XXXX; XX, X: xx-xx)

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“…[3][4][5][6][7][8][9] In transulnar catheterization, investigators in a small single-center prospective study showed a low incidence of vascular sequelae, in which 2 patients (0.4%) had developed major forearm hematomas that resolved without clinical consequences. 10 In a large prospective study of more than 10,000 patients, the overall vascular sequela rate in transradial percutaneous coronary procedures was 0.5%, and there were 2 cases of compartment syndrome.…”

Section: Discussionmentioning

confidence: 99%

Compartment Syndrome of the Hand: A Rare Sequela of Transradial Cardiac Catheterization

Jue¹,

Karam²,

Mejía³

et al. 2017

Texas Heart Institute Journal

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T he transradial approach to percutaneous coronary intervention (PCI) has lower rates of bleeding and vascular sequelae than does the femoral approach. Compartment syndrome of the forearm is a rare vascular sequela associated with radial access. We describe an unusual case of compartment syndrome of the hand without involvement of the forearm. Case ReportIn September 2015, a 64-year-old, right-handed man with a medical history of hypertension and end-stage renal disease (on hemodialysis) presented for elective outpatient cardiac catheterization. He had a systolic blood pressure (BP) of 190 mmHg. The patient's body mass index was 17.6 kg/m 2 (weight, 52 kg; height, 1.7 m). He had fair cardiac functional capacity and normal left ventricular function (ejection fraction, 0.55) on echocardiography.The patient's preprocedural laboratory values included an international normalized ratio of 1.0, a prothrombin time of 10.9 s, a baseline hemoglobin level of 9.1 g/dL, and a platelet count of 202,000/µL. He was given 325 mg of aspirin on the morning of the procedure.We attained, on the second attempt, right radial artery access with use of the frontwall (bare-needle) technique, and we inserted a 5F hydrophilic sheath 10 cm in length. Intra-arterial verapamil (5 mg) and intravenous unfractionated heparin (UFH) (5,000 U) were given at this point. Diagnostic cardiac catheterization revealed a mild stenosis involving the distal left main coronary artery (LMCA). The first obtuse marginal branch of the left circumflex coronary artery was a moderate-caliber vessel with a 90% eccentric stenosis. The sheath was upsized to 6F, and a 6F extra-backup guiding catheter engaged the LMCA without incident. The patient was given an additional 7,000 U of UFH, which resulted in an activated clotting time of 413 s. We successfully performed PCI of the obtuse marginal branch, using 2 drug-eluting stents. There was a good angiographic result-Thrombolysis in Myocardial Infarction-3 flow and no evidence of dissection. After the procedure, we gave the patient a 600-mg loading dose of clopidogrel.Upon completion of the procedure, we removed the right radial arterial sheath and placed an air-filled, transradial vascular hemostasis band over the access site. A small hematoma was noted proximal to the wristband, so a second vascular band was placed over that area. Pre-and postprocedural Barbeau tests with use of combined plethysmography and pulse oximetry recordings revealed normal findings consistent with patent radial and ulnar arteries. The patient was admitted to the inpatient medical service for post-PCI monitoring.Two hours later, nurses reported substantial bleeding upon initial deflation of 3 cc of air from the wristband, which was immediately reinflated per protocol. How-

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Vascular Complications Following Transradial and Transulnar Coronary Angiography in 1600 Consecutive Patients

Abstract: Although infrequent, surveillance for major complications should be encouraged after forearm coronary procedures.

Cited by 25 publications

References 11 publications

Severe Dorsal Hand Laceration Secondary to Compartment Syndrome Following Transradial Coronary Intervention

Severe Dorsal Hand Laceration Secondary to Compartment Syndrome Following Transradial Coronary Intervention

Comparison of long-term radial artery occlusion following trans-radial coronary intervention using 6-french versus 7-french sheaths

Compartment Syndrome of the Hand: A Rare Sequela of Transradial Cardiac Catheterization

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