Radial Artery Occlusion After Transradial Access for Coronary Interventions

TL;DR

This study examines how often radial artery blockage occurs after a common heart procedure and finds it's more common in older patients.

Contribution

The study provides new data on radial artery occlusion rates and identifies age as a significant risk factor following transradial coronary interventions.

Findings

Radial artery occlusion occurred in 5.3% of patients after transradial coronary procedures.

Patients over 60 years old had significantly higher RAO rates (7.1%) compared to younger patients (3.8%).

The overall risk of RAO is low, but age remains a significant predictor.

Abstract

Background

Transradial access (TRA) is a medical procedure primarily used for percutaneous coronary interventions (PCI) and cardiac catheterization. Based on the recently published Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of AngioX (MATRIX) trial, TRA is being used more frequently than transfemoral access (TFA) since it has reduced rates of bleeding and fatality. A structural complication of TRA is radial artery occlusion (RAO), which may cause temporary pain to limit TRA in the future.

Objective

This study aimed to investigate the onset and risk factors of RAO following TRA for coronary interventions.

Material and methods

An observational study was conducted at Fauji Foundation Hospital in Peshawar, Pakistan. The study included 1,680 patients recruited between April 2021 to December 2023. Fifty-eight patients were lost to follow-up, while another 95 patients did not come for a visit within the study period. The final study, therefore, included 1,527 patients.

Results

The mean age of patients was 58.09 ± 8.07 years. Patients were divided into two age groups (greater or less than 60 years). Diagnostic angiograms were completed for 955 patients, while 572 also underwent PCI. The overall RAO onset was 81 (5.3%). There was a significantly higher RAO onset in patients over 60 years old (7.1 vs 3.8%, p = 0.003).

Conclusion

Overall, the risk of RAO is low following TRA. The risk of RAO is significantly higher in people aged over 60 years.