Low rate of access site complications after transradial coronary catheterization: A prospective ultrasound study

Background: Transradial artery (TRA) left heart catheterization is an increasingly used technique for both diagnostic and interventional coronary procedures. This study evaluates the incidence of access site complications in the current interventional era. Methods and results: A total of 507 procedu...

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Main Authors: Violeta Mattea, Carsten Salomon, Niels Menck, Philipp Lauten, Frank Michael Malur, Anja Schade, Frank Steinborn, Lisa Costello-Boerrigter, Axel Neumeister, Harald Lapp
Format: Article
Language:English
Published: Elsevier 2017-03-01
Series:International Journal of Cardiology: Heart & Vasculature
Subjects:
Online Access:http://www.sciencedirect.com/science/article/pii/S2352906716301002
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author Violeta Mattea
Carsten Salomon
Niels Menck
Philipp Lauten
Frank Michael Malur
Anja Schade
Frank Steinborn
Lisa Costello-Boerrigter
Axel Neumeister
Harald Lapp
author_facet Violeta Mattea
Carsten Salomon
Niels Menck
Philipp Lauten
Frank Michael Malur
Anja Schade
Frank Steinborn
Lisa Costello-Boerrigter
Axel Neumeister
Harald Lapp
author_sort Violeta Mattea
collection DOAJ
description Background: Transradial artery (TRA) left heart catheterization is an increasingly used technique for both diagnostic and interventional coronary procedures. This study evaluates the incidence of access site complications in the current interventional era. Methods and results: A total of 507 procedures were performed under standardized conditions. Each procedure was performed using high levels of anticoagulation, hydrophilic sheaths, and short post-procedural compression times. Vascular complications were assessed one day after TRA catheterization using Duplex sonography and classified according to the necessity of additional medical intervention. A simple questionnaire helped identifying upper extremity neurologic or motor complications. Vascular complications were detected in 12 patients (2.36%): radial artery occlusion was detected in 9 patients (1.77%), 1 patient developed an AV-fistula (0.19%), and 2 patients had pseudoaneurysms (0.38%). None of the patients required specialized medical or surgical intervention. Under our procedural conditions, small radial artery diameter was the only significant predictor for the development of post-procedural vascular complications (2.11 ± 0.42 mm vs 2.52 ± 0.39 mm, p = 0.001). None of the previously reported risk factors, namely, advanced renal failure, diabetes, acuteness/complexity of procedure, or sheath and catheter size significantly influenced the rate of vascular complications. No major hematoma or local neurologic or motor complications were identified. Conclusions: Using current techniques and materials, we report a very low rate of local complications associated with TRA catheterization.
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spelling doaj.art-741aad8f00e44bb1829b72097096d8c12022-12-21T17:48:53ZengElsevierInternational Journal of Cardiology: Heart & Vasculature2352-90672017-03-0114C465210.1016/j.ijcha.2016.12.003Low rate of access site complications after transradial coronary catheterization: A prospective ultrasound studyVioleta Mattea0Carsten Salomon1Niels Menck2Philipp Lauten3Frank Michael Malur4Anja Schade5Frank Steinborn6Lisa Costello-Boerrigter7Axel Neumeister8Harald Lapp9HELIOS Klinikum Erfurt, Department of Internal Medicine III, Nordhäuser Straße 74, 99089, Erfurt, GermanyHELIOS Klinikum Erfurt, Department of Internal Medicine III, Nordhäuser Straße 74, 99089, Erfurt, GermanyHELIOS Klinikum Erfurt, Department of Internal Medicine III, Nordhäuser Straße 74, 99089, Erfurt, GermanyHELIOS Klinikum Erfurt, Department of Internal Medicine III, Nordhäuser Straße 74, 99089, Erfurt, GermanyHELIOS Klinikum Erfurt, Department of Internal Medicine III, Nordhäuser Straße 74, 99089, Erfurt, GermanyHELIOS Klinikum Erfurt, Department of Internal Medicine III, Nordhäuser Straße 74, 99089, Erfurt, GermanyHELIOS Klinikum Erfurt, Department of Internal Medicine III, Nordhäuser Straße 74, 99089, Erfurt, GermanyHELIOS Klinikum Erfurt, Department of Internal Medicine III, Nordhäuser Straße 74, 99089, Erfurt, GermanyHELIOS Klinikum Erfurt, Department of Angiology, Nordhäuser Straße 74, 99089, Erfurt, GermanyHELIOS Klinikum Erfurt, Department of Internal Medicine III, Nordhäuser Straße 74, 99089, Erfurt, GermanyBackground: Transradial artery (TRA) left heart catheterization is an increasingly used technique for both diagnostic and interventional coronary procedures. This study evaluates the incidence of access site complications in the current interventional era. Methods and results: A total of 507 procedures were performed under standardized conditions. Each procedure was performed using high levels of anticoagulation, hydrophilic sheaths, and short post-procedural compression times. Vascular complications were assessed one day after TRA catheterization using Duplex sonography and classified according to the necessity of additional medical intervention. A simple questionnaire helped identifying upper extremity neurologic or motor complications. Vascular complications were detected in 12 patients (2.36%): radial artery occlusion was detected in 9 patients (1.77%), 1 patient developed an AV-fistula (0.19%), and 2 patients had pseudoaneurysms (0.38%). None of the patients required specialized medical or surgical intervention. Under our procedural conditions, small radial artery diameter was the only significant predictor for the development of post-procedural vascular complications (2.11 ± 0.42 mm vs 2.52 ± 0.39 mm, p = 0.001). None of the previously reported risk factors, namely, advanced renal failure, diabetes, acuteness/complexity of procedure, or sheath and catheter size significantly influenced the rate of vascular complications. No major hematoma or local neurologic or motor complications were identified. Conclusions: Using current techniques and materials, we report a very low rate of local complications associated with TRA catheterization.http://www.sciencedirect.com/science/article/pii/S2352906716301002Coronary angiographyTransradial catheterizationRadial artery occlusionAccess site complications
spellingShingle Violeta Mattea
Carsten Salomon
Niels Menck
Philipp Lauten
Frank Michael Malur
Anja Schade
Frank Steinborn
Lisa Costello-Boerrigter
Axel Neumeister
Harald Lapp
Low rate of access site complications after transradial coronary catheterization: A prospective ultrasound study
International Journal of Cardiology: Heart & Vasculature
Coronary angiography
Transradial catheterization
Radial artery occlusion
Access site complications
title Low rate of access site complications after transradial coronary catheterization: A prospective ultrasound study
title_full Low rate of access site complications after transradial coronary catheterization: A prospective ultrasound study
title_fullStr Low rate of access site complications after transradial coronary catheterization: A prospective ultrasound study
title_full_unstemmed Low rate of access site complications after transradial coronary catheterization: A prospective ultrasound study
title_short Low rate of access site complications after transradial coronary catheterization: A prospective ultrasound study
title_sort low rate of access site complications after transradial coronary catheterization a prospective ultrasound study
topic Coronary angiography
Transradial catheterization
Radial artery occlusion
Access site complications
url http://www.sciencedirect.com/science/article/pii/S2352906716301002
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