Upper Extremity Function following Transradial Percutaneous Coronary Intervention: Results of the ARCUS Trial
Objectives. To determine the incidence of upper extremity dysfunction (UED), after a transradial percutaneous coronary intervention (TR-PCI). Background. Transradial approach (TRA) is the preferred approach for coronary interventions. However, upper extremity complications may be underreported. Meth...
| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
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Hindawi-Wiley
2022-01-01
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| Series: | Journal of Interventional Cardiology |
| Online Access: | http://dx.doi.org/10.1155/2022/6858962 |
| _version_ | 1798036306092097536 |
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| author | Eva M. Zwaan Elena S. Cheung Alexander J. J. IJsselmuiden Carlo A. J. Holtzer Ton A. R. Schreuders Marcel J. M Kofflard J. Henk Coert |
| author_facet | Eva M. Zwaan Elena S. Cheung Alexander J. J. IJsselmuiden Carlo A. J. Holtzer Ton A. R. Schreuders Marcel J. M Kofflard J. Henk Coert |
| author_sort | Eva M. Zwaan |
| collection | DOAJ |
| description | Objectives. To determine the incidence of upper extremity dysfunction (UED), after a transradial percutaneous coronary intervention (TR-PCI). Background. Transradial approach (TRA) is the preferred approach for coronary interventions. However, upper extremity complications may be underreported. Methods. The ARCUS was designed as a prospective cohort study, including 502 consecutive patients admitted for PCI. Patients treated with transfemoral PCI (TF-PCI) acted as a control group. A composite score of physical examinations and questionnaires was used for determining UED. Clinical outcomes were monitored during six months of follow-up, with its primary endpoint at two weeks. Results. A total of 440 TR-PCI and 62 control patients were included. Complete case analysis (n = 330) at 2 weeks of follow-up showed that UED in the TR-PCI group was significantly higher than that in the TF-PCI group: 32.7% versus 13.9%, respectively (p=0.04). The three impaired variables most contributing to UED were impaired elbow extension, wrist flexion, and extension. Multivariate logistic regression showed that smokers were almost three times more likely to develop UED. Conclusions. This study demonstrates that UED seems to occur two times more in TR-PCI than in TF-PCI at 2 weeks of follow-up. However, no significant long-term difference or difference between the intervention arm and the contralateral arm was found at all timepoints. |
| first_indexed | 2024-04-11T21:11:05Z |
| format | Article |
| id | doaj.art-4c999dc010534e4b988a24e01674ea45 |
| institution | Directory Open Access Journal |
| issn | 1540-8183 |
| language | English |
| last_indexed | 2024-04-11T21:11:05Z |
| publishDate | 2022-01-01 |
| publisher | Hindawi-Wiley |
| record_format | Article |
| series | Journal of Interventional Cardiology |
| spelling | doaj.art-4c999dc010534e4b988a24e01674ea452022-12-22T04:03:01ZengHindawi-WileyJournal of Interventional Cardiology1540-81832022-01-01202210.1155/2022/6858962Upper Extremity Function following Transradial Percutaneous Coronary Intervention: Results of the ARCUS TrialEva M. Zwaan0Elena S. Cheung1Alexander J. J. IJsselmuiden2Carlo A. J. Holtzer3Ton A. R. Schreuders4Marcel J. M Kofflard5J. Henk Coert6Department of Plastic Surgery and Reconstructive SurgeryDepartment of Plastic Surgery and Reconstructive SurgeryDepartment of CardiologyDepartment of Plastic Surgery and Hand SurgeryDepartment of Plastic Surgery and Reconstructive SurgeryDepartment of CardiologyDepartment of Plastic Surgery and Reconstructive SurgeryObjectives. To determine the incidence of upper extremity dysfunction (UED), after a transradial percutaneous coronary intervention (TR-PCI). Background. Transradial approach (TRA) is the preferred approach for coronary interventions. However, upper extremity complications may be underreported. Methods. The ARCUS was designed as a prospective cohort study, including 502 consecutive patients admitted for PCI. Patients treated with transfemoral PCI (TF-PCI) acted as a control group. A composite score of physical examinations and questionnaires was used for determining UED. Clinical outcomes were monitored during six months of follow-up, with its primary endpoint at two weeks. Results. A total of 440 TR-PCI and 62 control patients were included. Complete case analysis (n = 330) at 2 weeks of follow-up showed that UED in the TR-PCI group was significantly higher than that in the TF-PCI group: 32.7% versus 13.9%, respectively (p=0.04). The three impaired variables most contributing to UED were impaired elbow extension, wrist flexion, and extension. Multivariate logistic regression showed that smokers were almost three times more likely to develop UED. Conclusions. This study demonstrates that UED seems to occur two times more in TR-PCI than in TF-PCI at 2 weeks of follow-up. However, no significant long-term difference or difference between the intervention arm and the contralateral arm was found at all timepoints.http://dx.doi.org/10.1155/2022/6858962 |
| spellingShingle | Eva M. Zwaan Elena S. Cheung Alexander J. J. IJsselmuiden Carlo A. J. Holtzer Ton A. R. Schreuders Marcel J. M Kofflard J. Henk Coert Upper Extremity Function following Transradial Percutaneous Coronary Intervention: Results of the ARCUS Trial Journal of Interventional Cardiology |
| title | Upper Extremity Function following Transradial Percutaneous Coronary Intervention: Results of the ARCUS Trial |
| title_full | Upper Extremity Function following Transradial Percutaneous Coronary Intervention: Results of the ARCUS Trial |
| title_fullStr | Upper Extremity Function following Transradial Percutaneous Coronary Intervention: Results of the ARCUS Trial |
| title_full_unstemmed | Upper Extremity Function following Transradial Percutaneous Coronary Intervention: Results of the ARCUS Trial |
| title_short | Upper Extremity Function following Transradial Percutaneous Coronary Intervention: Results of the ARCUS Trial |
| title_sort | upper extremity function following transradial percutaneous coronary intervention results of the arcus trial |
| url | http://dx.doi.org/10.1155/2022/6858962 |
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