Distal Radial Artery Access for Recanalization of Radial Artery Occlusion and Repeat Intervention: A Single Center Experience
<b>Background</b>: Once occluded, the radial artery becomes unsuitable for repeat interventions and obligates the need for alternative vascular access, such as the femoral approach, which is not encouraged by current guidelines. With the dissemination of distal radial access (DRA), which...
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| Format: | Article |
| Language: | English |
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MDPI AG
2022-11-01
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| Series: | Journal of Clinical Medicine |
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| Online Access: | https://www.mdpi.com/2077-0383/11/23/6916 |
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| author | Alexandru Achim Kornél Kákonyi Zoltán Jambrik Dorottya Olajos Attila Nemes Olivier F. Bertrand Zoltán Ruzsa |
| author_facet | Alexandru Achim Kornél Kákonyi Zoltán Jambrik Dorottya Olajos Attila Nemes Olivier F. Bertrand Zoltán Ruzsa |
| author_sort | Alexandru Achim |
| collection | DOAJ |
| description | <b>Background</b>: Once occluded, the radial artery becomes unsuitable for repeat interventions and obligates the need for alternative vascular access, such as the femoral approach, which is not encouraged by current guidelines. With the dissemination of distal radial access (DRA), which allows the cannulation of the artery in its distal segment and which remains patent even in the case of radial artery occlusion (RAO), the option to perform angioplasty at this level becomes feasible. <b>Methods</b>: Thirty patients with RAO were enrolled in this pilot study. Recanalization was performed through DRA using hydrophilic guidewires. The feasibility endpoint was procedural success, namely the successful RAO recanalization, the efficacy endpoint was patency of the artery at 30 days, and the safety endpoint was the absence of periprocedural vascular major complications or major adverse cardiac and cerebrovascular events. <b>Results</b>: The mean age of the patients was 63 ± 11 years, and 15 patients (50%) were men. Most patients had asymptomatic RAO (<i>n</i> = 28, 93.3%), and only two (6.6%) reported numbness in their hands. The most common indication for the procedure was PCI (19, 63.2%). Total procedural time was 41 ± 22 min, while the amount of contrast used was 140 ± 28 mL. Procedural success was 100% (<i>n</i> = 30). Moreover, there were no major vascular complications (0%); only two small hematomas were described (10%) and one had an angiographically visible perforation (3%). One case of periprocedural stroke was reported (3%), with onset immediately after the procedure and recovering 24 h later. Twenty-seven radial arteries (90%) remained patent at the one-month follow-up. <b>Conclusions</b>: RAO recanalization is feasible and safe, and by using dedicated hydrophilic guidewires, the success rate is high without significantly increasing procedural time or the amount of used contrast. |
| first_indexed | 2024-03-09T17:44:05Z |
| format | Article |
| id | doaj.art-f84a537ca4294b048ae66d336a6bfc6d |
| institution | Directory Open Access Journal |
| issn | 2077-0383 |
| language | English |
| last_indexed | 2024-03-09T17:44:05Z |
| publishDate | 2022-11-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Journal of Clinical Medicine |
| spelling | doaj.art-f84a537ca4294b048ae66d336a6bfc6d2023-11-24T11:19:52ZengMDPI AGJournal of Clinical Medicine2077-03832022-11-011123691610.3390/jcm11236916Distal Radial Artery Access for Recanalization of Radial Artery Occlusion and Repeat Intervention: A Single Center ExperienceAlexandru Achim0Kornél Kákonyi1Zoltán Jambrik2Dorottya Olajos3Attila Nemes4Olivier F. Bertrand5Zoltán Ruzsa6Internal Medicine Department, Division of Invasive Cardiology, University of Szeged, 6720 Szeged, HungaryInternal Medicine Department, Division of Invasive Cardiology, University of Szeged, 6720 Szeged, HungaryInternal Medicine Department, Division of Invasive Cardiology, University of Szeged, 6720 Szeged, HungaryBács-Kiskun County Hospital, Teaching Hospital of the Szent-Györgyi Albert Medical University, 6725 Kecskemét, HungaryInternal Medicine Department, Division of Invasive Cardiology, University of Szeged, 6720 Szeged, HungaryCardio-Thoracic Center, University Laval, Quebec City, QC G1V 0A6, CanadaInternal Medicine Department, Division of Invasive Cardiology, University of Szeged, 6720 Szeged, Hungary<b>Background</b>: Once occluded, the radial artery becomes unsuitable for repeat interventions and obligates the need for alternative vascular access, such as the femoral approach, which is not encouraged by current guidelines. With the dissemination of distal radial access (DRA), which allows the cannulation of the artery in its distal segment and which remains patent even in the case of radial artery occlusion (RAO), the option to perform angioplasty at this level becomes feasible. <b>Methods</b>: Thirty patients with RAO were enrolled in this pilot study. Recanalization was performed through DRA using hydrophilic guidewires. The feasibility endpoint was procedural success, namely the successful RAO recanalization, the efficacy endpoint was patency of the artery at 30 days, and the safety endpoint was the absence of periprocedural vascular major complications or major adverse cardiac and cerebrovascular events. <b>Results</b>: The mean age of the patients was 63 ± 11 years, and 15 patients (50%) were men. Most patients had asymptomatic RAO (<i>n</i> = 28, 93.3%), and only two (6.6%) reported numbness in their hands. The most common indication for the procedure was PCI (19, 63.2%). Total procedural time was 41 ± 22 min, while the amount of contrast used was 140 ± 28 mL. Procedural success was 100% (<i>n</i> = 30). Moreover, there were no major vascular complications (0%); only two small hematomas were described (10%) and one had an angiographically visible perforation (3%). One case of periprocedural stroke was reported (3%), with onset immediately after the procedure and recovering 24 h later. Twenty-seven radial arteries (90%) remained patent at the one-month follow-up. <b>Conclusions</b>: RAO recanalization is feasible and safe, and by using dedicated hydrophilic guidewires, the success rate is high without significantly increasing procedural time or the amount of used contrast.https://www.mdpi.com/2077-0383/11/23/6916radial artery occlusionradial recanalizationdistal radial access |
| spellingShingle | Alexandru Achim Kornél Kákonyi Zoltán Jambrik Dorottya Olajos Attila Nemes Olivier F. Bertrand Zoltán Ruzsa Distal Radial Artery Access for Recanalization of Radial Artery Occlusion and Repeat Intervention: A Single Center Experience Journal of Clinical Medicine radial artery occlusion radial recanalization distal radial access |
| title | Distal Radial Artery Access for Recanalization of Radial Artery Occlusion and Repeat Intervention: A Single Center Experience |
| title_full | Distal Radial Artery Access for Recanalization of Radial Artery Occlusion and Repeat Intervention: A Single Center Experience |
| title_fullStr | Distal Radial Artery Access for Recanalization of Radial Artery Occlusion and Repeat Intervention: A Single Center Experience |
| title_full_unstemmed | Distal Radial Artery Access for Recanalization of Radial Artery Occlusion and Repeat Intervention: A Single Center Experience |
| title_short | Distal Radial Artery Access for Recanalization of Radial Artery Occlusion and Repeat Intervention: A Single Center Experience |
| title_sort | distal radial artery access for recanalization of radial artery occlusion and repeat intervention a single center experience |
| topic | radial artery occlusion radial recanalization distal radial access |
| url | https://www.mdpi.com/2077-0383/11/23/6916 |
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