Purpose
Identify the predictors of radial artery occlusion (RAO) and evaluate the possibility and feasibility of recanalization of RAo.
Methods and materials
Factors that cause radial artery occlusion (RA) are analyzed.These are factors:
мsmall diameter of the RA (d ≤ 2.0 mm) or inconsistency of the size of thedeviceand RA;
high RAbifurcation;
spasm RA;
tortuosityof the RA (Loop);
mediacalcinosis;
Injury to the wall of the radial artery and the long-term location of the catheter (introducer) in the RA;
incorrect hemostasis;
anticoagulation;
9.Distal RA (dRA)?
Recanalization of occlusions was performed retrogradely (accessed through the dRA on the hand) and antegradely (accessed through the ipsilateral ulnar artery) with the...
Results
TENDERA RCT (n=240).
RA (norm) n=215
(93,7%)
RAO n=15
(6,3%)
Sex
M – 59%
F – 41%
M – 44%
F – 56%
Diameter RA (mm)
Δ2,6 ²
[2,3 – 2,9] ³
Δ 2,4 ²
[2,1 – 2,5] ³
5 Fr n=56 (24,4%) ⁴
6 Fr n=174 (75,6%) ⁴
5 Fr n=50 (89,3%)
6 Fr n=165 (94,8%)
5 Fr n=6 (10,7%)
6 Fr n=9 (5,2%)
Operation time (min)
Δ 25,2 ²
[6 – 38] ³
Δ 36,11 ²
[20 – 30] ³
High RA bifurcation...
Conclusion
It is difficult to determine the only underlying cause of RAO;
RAO is a low-symptom or asymptomatic complication, but its recanalization makes it possible to reuse RA during endovascular procedures;
The success of retrograde recanalization is higher than that of antegrade recanalization, but long-term results (reocclusion) are worse, both methods have a risk of embolic complications;
After RAO recanalization, the dynamic strength of the hand increases, but patients do not feel it.
Personal information and conflict of interest
K. Aleksandr; Saint-Petersburg/RU - Author at North-West State Medical University named after I.I. Mechnikov - Patent Holder at North-West State Medical University named after I.I. Mechnikov P. Podmetin; Saint-Petersburg/RU - Speaker at North-West State Medical University named after I.I. Mechnikov I. Kochanov; Saint-Petersburg/RU - Author at North-West State Medical University named after I.I. Mechnikov S. Seletskiy; Saint-Petersburg/RU - Author at North-West State Medical University named after I.I. Mechnikov
References
Kiemeneij, F. Percutaneous transradial artery approach for coronary stent implantation / F. Kiemeneij, G. J. Laarman // Cathet Cardiavasc Diagn. – 1993; 30:173–78.
Babunashvilli A.M., Kartashov D.S. In: V.Sh. Merzlyakova editor. Guidance on the application of radial access in interventional angiocardiography (best clinical practice for transradial endovascular interventions).-М.: АСВ Рubl.; 2017.
Samir B. Pancholy, Tejas M. Patel. Effect of duration of hemostatic compression on radial artery occlusion after transradial access. Catheterization and Cardiovascular Interventions. 2012;179(1):78-81.