The Impact of Using a Larger Forearm Artery for Percutaneous Coronary Interventions on Hand Strength: A Randomized Controlled Trial
(1) Background: The exact mechanism underlying hand strength reduction (HSR) after coronary angiography with transradial access (TRA) or transulnar access (TUA) remains unknown. (2) Methods: This study aimed to assess the impact of using a larger or smaller forearm artery access on the incidence of...
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MDPI AG
2021-03-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/10/5/1099 |
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| author | Pawel Lewandowski Anna Zuk Tomasz Slomski Pawel Maciejewski Bogumil Ramotowski Andrzej Budaj |
| author_facet | Pawel Lewandowski Anna Zuk Tomasz Slomski Pawel Maciejewski Bogumil Ramotowski Andrzej Budaj |
| author_sort | Pawel Lewandowski |
| collection | DOAJ |
| description | (1) Background: The exact mechanism underlying hand strength reduction (HSR) after coronary angiography with transradial access (TRA) or transulnar access (TUA) remains unknown. (2) Methods: This study aimed to assess the impact of using a larger or smaller forearm artery access on the incidence of HSR at 30-day follow-up. This was a prospective randomized trial including patients referred for elective coronary angiography or percutaneous coronary intervention. Based on the pre-procedural ultrasound examination, the larger artery was identified. Patients were randomized to larger radial artery (RA) or ulnar artery (UA) or a group with smaller RA/UA. The primary endpoint was the incidence of HSR, while the secondary endpoint was the incidence of subjective HSR, paresthesia, and any hand pain. (3) Results: We enrolled 200 patients (107 men and 93 women; mean age 68 ± 8 years) between 2017 and 2018. Due to crossover between TRA and TUA, there were 57% (<i>n</i> = 115) patients in larger RA/UA and 43% (<i>n</i> = 85) patients in smaller RA/UA. HSR occurred in 29% (<i>n</i> = 33) patients in larger RA/UA and 47% (<i>n</i> = 40) patients in smaller RA/UA (<i>p</i> = 0.008). Subjective HSR was observed in 10% (<i>n</i> = 12) patients in larger RA/UA and 21% (<i>n</i> = 18) patients in smaller RA/UA (<i>p</i> = 0.03). Finally, paresthesia was noted in 7% (<i>n</i> = 8) patients in larger RA/UA and 22% (<i>n</i> = 15) in smaller RA/UA (<i>p</i> = 002). Independent factors of HSR were larger RA/UA (OR 0.45; 95% CI, 0.24–0.82; <i>p</i> < 0.01) and the use of TRA (OR 1.87; 95% CI, 1.01–34; <i>p</i> < 0.05). (4) Conclusions: The use of a larger artery as vascular access was associated with a lower incidence of HSR at 30-day follow-up. |
| first_indexed | 2024-03-09T05:12:39Z |
| format | Article |
| id | doaj.art-15059c5091e9423ab324862c1f800397 |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T05:12:39Z |
| publishDate | 2021-03-01 |
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| spelling | doaj.art-15059c5091e9423ab324862c1f8003972023-12-03T12:47:19ZengMDPI AGJournal of Clinical Medicine2077-03832021-03-01105109910.3390/jcm10051099The Impact of Using a Larger Forearm Artery for Percutaneous Coronary Interventions on Hand Strength: A Randomized Controlled TrialPawel Lewandowski0Anna Zuk1Tomasz Slomski2Pawel Maciejewski3Bogumil Ramotowski4Andrzej Budaj5Centre of Postgraduate Medical Education, Cardiology Department, Grochowski Hospital, 04-073 Warsaw, PolandCentre of Postgraduate Medical Education, Cardiology Department, Grochowski Hospital, 04-073 Warsaw, PolandCentre of Postgraduate Medical Education, Cardiology Department, Grochowski Hospital, 04-073 Warsaw, PolandCentre of Postgraduate Medical Education, Cardiology Department, Grochowski Hospital, 04-073 Warsaw, PolandCentre of Postgraduate Medical Education, Cardiology Department, Grochowski Hospital, 04-073 Warsaw, PolandCentre of Postgraduate Medical Education, Cardiology Department, Grochowski Hospital, 04-073 Warsaw, Poland(1) Background: The exact mechanism underlying hand strength reduction (HSR) after coronary angiography with transradial access (TRA) or transulnar access (TUA) remains unknown. (2) Methods: This study aimed to assess the impact of using a larger or smaller forearm artery access on the incidence of HSR at 30-day follow-up. This was a prospective randomized trial including patients referred for elective coronary angiography or percutaneous coronary intervention. Based on the pre-procedural ultrasound examination, the larger artery was identified. Patients were randomized to larger radial artery (RA) or ulnar artery (UA) or a group with smaller RA/UA. The primary endpoint was the incidence of HSR, while the secondary endpoint was the incidence of subjective HSR, paresthesia, and any hand pain. (3) Results: We enrolled 200 patients (107 men and 93 women; mean age 68 ± 8 years) between 2017 and 2018. Due to crossover between TRA and TUA, there were 57% (<i>n</i> = 115) patients in larger RA/UA and 43% (<i>n</i> = 85) patients in smaller RA/UA. HSR occurred in 29% (<i>n</i> = 33) patients in larger RA/UA and 47% (<i>n</i> = 40) patients in smaller RA/UA (<i>p</i> = 0.008). Subjective HSR was observed in 10% (<i>n</i> = 12) patients in larger RA/UA and 21% (<i>n</i> = 18) patients in smaller RA/UA (<i>p</i> = 0.03). Finally, paresthesia was noted in 7% (<i>n</i> = 8) patients in larger RA/UA and 22% (<i>n</i> = 15) in smaller RA/UA (<i>p</i> = 002). Independent factors of HSR were larger RA/UA (OR 0.45; 95% CI, 0.24–0.82; <i>p</i> < 0.01) and the use of TRA (OR 1.87; 95% CI, 1.01–34; <i>p</i> < 0.05). (4) Conclusions: The use of a larger artery as vascular access was associated with a lower incidence of HSR at 30-day follow-up.https://www.mdpi.com/2077-0383/10/5/1099complicationshand griptransradial accesstransulnar access |
| spellingShingle | Pawel Lewandowski Anna Zuk Tomasz Slomski Pawel Maciejewski Bogumil Ramotowski Andrzej Budaj The Impact of Using a Larger Forearm Artery for Percutaneous Coronary Interventions on Hand Strength: A Randomized Controlled Trial Journal of Clinical Medicine complications hand grip transradial access transulnar access |
| title | The Impact of Using a Larger Forearm Artery for Percutaneous Coronary Interventions on Hand Strength: A Randomized Controlled Trial |
| title_full | The Impact of Using a Larger Forearm Artery for Percutaneous Coronary Interventions on Hand Strength: A Randomized Controlled Trial |
| title_fullStr | The Impact of Using a Larger Forearm Artery for Percutaneous Coronary Interventions on Hand Strength: A Randomized Controlled Trial |
| title_full_unstemmed | The Impact of Using a Larger Forearm Artery for Percutaneous Coronary Interventions on Hand Strength: A Randomized Controlled Trial |
| title_short | The Impact of Using a Larger Forearm Artery for Percutaneous Coronary Interventions on Hand Strength: A Randomized Controlled Trial |
| title_sort | impact of using a larger forearm artery for percutaneous coronary interventions on hand strength a randomized controlled trial |
| topic | complications hand grip transradial access transulnar access |
| url | https://www.mdpi.com/2077-0383/10/5/1099 |
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