Long term radial artery occlusion following distal or proximal transradial artery access in invasive cardiovascular procedures
DOI:
https://doi.org/10.21776/ub.hsj.2025.006.02.10Keywords:
interventional cardiology, percutaneous coronary intervention, coronary artery diseaseAbstract
Background: Radial artery occlusion (RAO) is one of the most common consequences of transradial artery access (TRA) in invasive cardiovascular procedures; therefore, alternative approaches, such as distal radial artery access (DRA), emerged. This study compares proximal and distal radial access for long-term RAO.
Objectives: This study compares long-term RAO incidence with proximal and distal radial access following invasive cardiovascular procedures.
Material and Methods: This is a retrospective cohort study. The subjects comprised patients with heart disease who underwent invasive cardiovascular procedures using radial access at Dr. Hasan Sadikin General Hospital Bandung between July 2017 and December 2020. The patients were categorized into two groups based on their access type: proximal and distal. The incidence of long-term RAO was evaluated through Doppler ultrasound at least one-year post-TRA.
Results: The study included 107 patients (proximal = 72 patients; distal = 35 patients). The mean age was 58.2 ± 8.26 years, with a predominance of male patients (79.4%) and smokers (65.4%). The majority of procedures were interventional (58.2%). Baseline characteristics were comparable between the two groups, except for selecting the access side, which was more prevalent on the left side in the distal group. Long-term RAO occurred in 8 patients (7.48%), with 7 cases (9.72%) in the proximal group and 1 case (2.86%) in the distal group (p=0.269).
Conclusion: The study findings reveal no significant difference in the incidence of long-term RAO between proximal and distal radial access in invasive cardiovascular procedures.
References
1. Kern MJ. 1 - The Basics of Percutaneous Coronary Interventions. In: Kern MJ, Sorajja P, Lim MJ, eds. The Interventional Cardiac Catheterization Handbook (Fourth Edition): Elsevier; 2018:1-50.
2. Raharjo F, Anjarwani S. From joint to heart: Cardiovascular implications of rheumatoid arthritis. Deka in Medicine 2024;1 (3):e361. doi: 10.69863/dim.2024.e361.
3. Patel MR, Calhoon JH, Dehmer GJ, Grantham JA, Maddox TM, Maron DJ, et al. ACC/AATS/AHA/ASE/ASNC/SCAI/SCCT/STS 2017 Appropriate Use Criteria for Coronary Revascularization in Patients With Stable Ischemic Heart Disease: A Report of the American College of Cardiology Appropriate Use Criteria Task Force, American Association for Thoracic Surgery, American Heart Association, American Society of Echocardiography, American Society of Nuclear Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Cardiovascular Computed Tomography, and Society of Thoracic Surgeons. Journal of Nuclear Cardiology 2017;24 (5):1759-1792. doi: 10.1007/s12350-017-0917-9.
4. Duarte PVF, Lorenzo AD. Choosing the vascular access in interventional cardiology: evolution and contemporary practice. Heart, Vessels and Transplantation 2021;5 (3):123-130. doi: 10.24969/hvt.2021.260.
5. Rashid M, Kwok CS, Pancholy S, Chugh S, Kedev SA, Bernat I, et al. Radial Artery Occlusion After Transradial Interventions: A Systematic Review and Meta‐Analysis. Journal of the American Heart Association;5 (1):e002686. doi: 10.1161/JAHA.115.002686.
6. Bernat I, Aminian A, Pancholy S, Mamas M, Gaudino M, Nolan J, et al. Best Practices for the Prevention of Radial Artery Occlusion After Transradial Diagnostic Angiography and Intervention: An International Consensus Paper. JACC: Cardiovascular Interventions 2019;12 (22):2235-2246. doi: doi.org/10.1016/j.jcin.2019.07.043.
7. Eid-Lidt G, Rivera Rodríguez A, Jimenez Castellanos J, Farjat Pasos JI, Estrada López KE, Gaspar J. Distal Radial Artery Approach to Prevent Radial Artery Occlusion Trial. JACC: Cardiovascular Interventions 2021;14 (4):378-385. doi: 10.1016/j.jcin.2020.10.013.
8. Nugroho CW, Suryantoro SD, Yuliasih Y, Rosyid AN, Asmarawati TP, Andrianto L, et al. Optimal use of tocilizumab for severe and critical COVID-19: a systematic review and meta-analysis. F1000Res 2021;10 (1):73. doi: 10.12688/f1000research.45046.1.
9. Sgueglia GA, Di Giorgio A, Gaspardone A, Babunashvili A. Anatomic Basis and Physiological Rationale of Distal Radial Artery Access for Percutaneous Coronary and Endovascular Procedures. JACC: Cardiovascular Interventions 2018;11 (20):2113-2119. doi: 10.1016/j.jcin.2018.04.045.
10. Corcos T. Distal radial access for coronary angiography and percutaneous coronary intervention: A state-of-the-art review. Catheterization and Cardiovascular Interventions 2019;93 (4):639-644. doi: 10.1002/ccd.28016.
11. Al-Azizi KM, Idris A, Christensen J, Hamandi M, Hale S, Martits-Chalangari K, et al. Distal Versus Proximal Radial Artery Access for Cardiac Catheterization and Intervention: Design and Rationale of the DIPRA Trial. Cardiovascular Revascularization Medicine 2022;35 (1):104-109. doi: 10.1016/j.carrev.2021.04.001.
12. Aminian A, Sgueglia GA, Wiemer M, Gasparini GL, Kefer J, Ruzsa Z, et al. Distal versus conventional radial access for coronary angiography and intervention: Design and rationale of DISCO RADIAL study. American Heart Journal 2022;244 (1):19-30. doi: doi.org/10.1016/j.ahj.2021.10.180.
13. Tsigkas G, Papageorgiou A, Moulias A, Kalogeropoulos AP, Papageorgopoulou C, Apostolos A, et al. Distal or Traditional Transradial Access Site for Coronary Procedures: A Single-Center, Randomized Study. JACC: Cardiovascular Interventions 2022;15 (1):22-32. doi: 10.1016/j.jcin.2021.09.037.
14. Buturak A, Gorgulu S, Norgaz T, Voyvoda N, Sahingoz Y, Degirmencioglu A, et al. The long-term incidence and predictors of radial artery occlusion following a transradial coronary procedure. Cardiol J 2014;21 (4):350-356. doi: 10.5603/CJ.a2013.0128.
15. Sgueglia GA, Lee B-K, Cho B-R, Babunashvili A, Lee JB, Lee J-W, et al. Distal Radial Access: Consensus Report of the First Korea-Europe Transradial Intervention Meeting. JACC: Cardiovascular Interventions 2021;14 (8):892-906. doi: 10.1016/j.jcin.2021.02.033.
16. Fajar JK, Harapan H. Socioeconomic and Attitudinal Variables Associated with Acceptance and Willingness to Pay Towards Dengue Vaccine: A Systematic Review. Archives of Clinical Infectious Diseases` 2017;12 (3):e13914. doi: 10.5812/archcid.13914.
17. Dhewantara PW, Jamil KF, Fajar JK, Saktianggi PP, Nusa R, Garjito TA, et al. Original Article: Decline of notified dengue infections in Indonesia in 2017: Discussion of the possible determinants. Narra J 2021;1 (1):e23. doi: 10.52225/narraj.v1i1.23.
18. Wardhani SO, Fajar JK, Nurarifah N, Hermanto DH, Fatonah S, Djajalaksana S, et al. The predictors of high titer of anti-SARS-CoV-2 antibody of convalescent plasma donors. Clin Epidemiol Glob Health 2021;11 (1):100763. doi: 10.1016/j.cegh.2021.100763.
19. Rahmianti N, Vendarani Y, Maulidiyah N. Right ventricular strain: Cardiovascular challenges in pulmonary diseases. Deka in Medicine 2024;1 (3):e359. doi: 10.69863/dim.2024.e359.
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