# Periprocedural Use of Heparin and Other Factors Contributing to the Patency of the Radial Artery Following Diagnostic Coronary Angiography

## TL;DR

This study examines factors affecting radial artery patency after coronary angiography, finding that heparin use is not essential for preventing artery blockage.

## Contribution

The study identifies new protective and risk factors for radial artery occlusion, challenging the necessity of heparin in all patients.

## Key findings

- Heparin administration does not significantly impact radial artery occlusion incidence.
- Longer fluoroscopy time and smaller vascular sheath are protective factors against RAO.
- Greater number of catheters, wider sheath, and atherosclerotic changes are risk factors for RAO.

## Abstract

Background: Diagnostic angiography of coronary arteries is one of the most common procedures in invasive cardiology and is mainly performed via the radial artery. Rapid improvements in the quality of the equipment and operator’s experience have changed the landscape of this procedure. Methods: In this study, 284 patients were analyzed to determine whether heparin administration should be a necessity for all patients to prevent radial artery occlusion (RAO). Moreover, the possible influence of 51 other factors on RAO was analyzed. Results: This study revealed that heparin administration does not have a significant impact on RAO incidence (p = 0.131). However, it was found that a longer fluoroscopy time (p < 0.001) and smaller (5F) vascular sheath (p = 0.001) might serve as protective factors against RAO. On the other hand, a greater number of catheters (p < 0.001), greater compression time (p = 0.001), wider (6F) vascular sheath (p = 0.002), spasm occurrence (p = 0.001), spasmolytic administration (p < 0.001) and atherosclerotic changes in the radial artery (p = 0.005) were risk factors for RAO. Conclusions: This study demonstrates the need for a more personalized approach to the patient when analyzing the individual risk of RAO. In our opinion, it is possible to omit heparin in cases of patients with an initial low risk of RAO or possible adverse drug reactions during diagnostic angiography.