Radial Artery and Ulnar Artery Occlusions Following Coronary Procedures and the Impact of Anticoagulation: ARTEMIS (Radial and Ulnar ARTEry Occlusion Meta‐AnalysIS) Systematic Review and Meta‐Analysis
BackgroundIncidence of radial artery occclusions (RAO) and ulnar artery occclusions (UAO) in coronary procedures, factors predisposing to forearm arteries occlusion, and the benefit of anticoaggulation vary significantly in existing literature. We sought to determine the incidence of RAO/UAO and the...
| Main Authors: | , , , , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2017-08-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| Subjects: | |
| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.116.005430 |
| _version_ | 1819178111624806400 |
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| author | George Hahalis Konstantinos Aznaouridis Gregory Tsigkas Periklis Davlouros Ioanna Xanthopoulou Nikolaos Koutsogiannis Ioanna Koniari Marianna Leopoulou Olivier Costerousse Dimitris Tousoulis Olivier F. Bertrand |
| author_facet | George Hahalis Konstantinos Aznaouridis Gregory Tsigkas Periklis Davlouros Ioanna Xanthopoulou Nikolaos Koutsogiannis Ioanna Koniari Marianna Leopoulou Olivier Costerousse Dimitris Tousoulis Olivier F. Bertrand |
| author_sort | George Hahalis |
| collection | DOAJ |
| description | BackgroundIncidence of radial artery occclusions (RAO) and ulnar artery occclusions (UAO) in coronary procedures, factors predisposing to forearm arteries occlusion, and the benefit of anticoaggulation vary significantly in existing literature. We sought to determine the incidence of RAO/UAO and the impact of anticoagulation intensity. Methods and ResultsMeta‐analysis of 112 studies assessing RAO and/or UAO (N=46 631) were included. Overall, there was no difference between crude RAO and UAO rates (5.2%; 95% confidence interval [CI], 4.4–6.0 versus 4.0%; 95% CI, 2.8–5.8; P=0.171). The early occlusion rate (in‐hospital or within 7 days after procedure) was higher than the late occlusion rate. The detection rate of occlusion was higher with vascular ultrasonography compared with clinical evaluation only. Low‐dose heparin was associated with a significantly higher RAO rate compared with high‐dose heparin (7.2%; 95% CI, 5.5–9.4 versus 4.3%; 95% CI, 3.5–5.3; Q=8.81; P=0.003). Early occlusions in low‐dose heparin cohorts mounted at 8.0% (95% CI, 6.1–10.6). The RAO rate was higher after diagnostic angiographies compared with coronary interventions, presumably attributed to the higher intensity of anticoagulation in the latter group. Hemostatic techniques (patent versus nonpatent hemostasis), geography (US versus non‐US cohorts) and sheath size did not impact on vessel patency. ConclusionsRAO and UAO occur with similar frequency and in the order of 7% to 8% when evaluated early by vascular ultrasonography following coronary procedures. More‐intensive anticoagulation is protective. Late recanalization occurs in a substantial minority of patients. |
| first_indexed | 2024-12-22T21:37:22Z |
| format | Article |
| id | doaj.art-674aef8cdc2c49d2a71a4cc535f8ae39 |
| institution | Directory Open Access Journal |
| issn | 2047-9980 |
| language | English |
| last_indexed | 2024-12-22T21:37:22Z |
| publishDate | 2017-08-01 |
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| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj.art-674aef8cdc2c49d2a71a4cc535f8ae392022-12-21T18:11:42ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802017-08-016810.1161/JAHA.116.005430Radial Artery and Ulnar Artery Occlusions Following Coronary Procedures and the Impact of Anticoagulation: ARTEMIS (Radial and Ulnar ARTEry Occlusion Meta‐AnalysIS) Systematic Review and Meta‐AnalysisGeorge Hahalis0Konstantinos Aznaouridis1Gregory Tsigkas2Periklis Davlouros3Ioanna Xanthopoulou4Nikolaos Koutsogiannis5Ioanna Koniari6Marianna Leopoulou7Olivier Costerousse8Dimitris Tousoulis9Olivier F. Bertrand10Patras University Hospital Rio, Rio Patras, GreeceHippokration Hospital, Athens Medical School, Athens, GreecePatras University Hospital Rio, Rio Patras, GreecePatras University Hospital Rio, Rio Patras, GreecePatras University Hospital Rio, Rio Patras, GreecePatras University Hospital Rio, Rio Patras, GreecePatras University Hospital Rio, Rio Patras, GreecePatras University Hospital Rio, Rio Patras, GreeceQuebec Heart‐Lung Institute, Quebec, CanadaHippokration Hospital, Athens Medical School, Athens, GreeceQuebec Heart‐Lung Institute, Quebec, CanadaBackgroundIncidence of radial artery occclusions (RAO) and ulnar artery occclusions (UAO) in coronary procedures, factors predisposing to forearm arteries occlusion, and the benefit of anticoaggulation vary significantly in existing literature. We sought to determine the incidence of RAO/UAO and the impact of anticoagulation intensity. Methods and ResultsMeta‐analysis of 112 studies assessing RAO and/or UAO (N=46 631) were included. Overall, there was no difference between crude RAO and UAO rates (5.2%; 95% confidence interval [CI], 4.4–6.0 versus 4.0%; 95% CI, 2.8–5.8; P=0.171). The early occlusion rate (in‐hospital or within 7 days after procedure) was higher than the late occlusion rate. The detection rate of occlusion was higher with vascular ultrasonography compared with clinical evaluation only. Low‐dose heparin was associated with a significantly higher RAO rate compared with high‐dose heparin (7.2%; 95% CI, 5.5–9.4 versus 4.3%; 95% CI, 3.5–5.3; Q=8.81; P=0.003). Early occlusions in low‐dose heparin cohorts mounted at 8.0% (95% CI, 6.1–10.6). The RAO rate was higher after diagnostic angiographies compared with coronary interventions, presumably attributed to the higher intensity of anticoagulation in the latter group. Hemostatic techniques (patent versus nonpatent hemostasis), geography (US versus non‐US cohorts) and sheath size did not impact on vessel patency. ConclusionsRAO and UAO occur with similar frequency and in the order of 7% to 8% when evaluated early by vascular ultrasonography following coronary procedures. More‐intensive anticoagulation is protective. Late recanalization occurs in a substantial minority of patients.https://www.ahajournals.org/doi/10.1161/JAHA.116.005430coronary angiographyradial occlusiontransradialtransulnarulnar occlusion |
| spellingShingle | George Hahalis Konstantinos Aznaouridis Gregory Tsigkas Periklis Davlouros Ioanna Xanthopoulou Nikolaos Koutsogiannis Ioanna Koniari Marianna Leopoulou Olivier Costerousse Dimitris Tousoulis Olivier F. Bertrand Radial Artery and Ulnar Artery Occlusions Following Coronary Procedures and the Impact of Anticoagulation: ARTEMIS (Radial and Ulnar ARTEry Occlusion Meta‐AnalysIS) Systematic Review and Meta‐Analysis Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease coronary angiography radial occlusion transradial transulnar ulnar occlusion |
| title | Radial Artery and Ulnar Artery Occlusions Following Coronary Procedures and the Impact of Anticoagulation: ARTEMIS (Radial and Ulnar ARTEry Occlusion Meta‐AnalysIS) Systematic Review and Meta‐Analysis |
| title_full | Radial Artery and Ulnar Artery Occlusions Following Coronary Procedures and the Impact of Anticoagulation: ARTEMIS (Radial and Ulnar ARTEry Occlusion Meta‐AnalysIS) Systematic Review and Meta‐Analysis |
| title_fullStr | Radial Artery and Ulnar Artery Occlusions Following Coronary Procedures and the Impact of Anticoagulation: ARTEMIS (Radial and Ulnar ARTEry Occlusion Meta‐AnalysIS) Systematic Review and Meta‐Analysis |
| title_full_unstemmed | Radial Artery and Ulnar Artery Occlusions Following Coronary Procedures and the Impact of Anticoagulation: ARTEMIS (Radial and Ulnar ARTEry Occlusion Meta‐AnalysIS) Systematic Review and Meta‐Analysis |
| title_short | Radial Artery and Ulnar Artery Occlusions Following Coronary Procedures and the Impact of Anticoagulation: ARTEMIS (Radial and Ulnar ARTEry Occlusion Meta‐AnalysIS) Systematic Review and Meta‐Analysis |
| title_sort | radial artery and ulnar artery occlusions following coronary procedures and the impact of anticoagulation artemis radial and ulnar artery occlusion meta analysis systematic review and meta analysis |
| topic | coronary angiography radial occlusion transradial transulnar ulnar occlusion |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.116.005430 |
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