# Short-term outcomes of unfractionated heparin vs. low molecular weight heparin in trans-radial coronary angiography: a comparative study

## TL;DR

This study compares unfractionated heparin and low molecular weight heparin in preventing radial artery occlusion during coronary angiography, finding that low molecular weight heparin is more effective.

## Contribution

The study provides new evidence that low molecular weight heparin reduces radial artery occlusion without increasing other complications in trans-radial coronary angiography.

## Key findings

- Low molecular weight heparin (LMWH) had a significantly lower radial artery occlusion rate (0.5%) compared to unfractionated heparin (3.5%).
- No significant differences were found in other complications like hematoma or arteriovenous fistula between the two groups.
- Both groups showed minor changes in arterial diameter and flow volume, but no major adverse effects.

## Abstract

Trans-radial access (TRA) for coronary angiography is preferred for its lower complication rates than trans-femoral access. However, radial artery occlusion (RAO) remains a significant concern.

The objective of this study was to assess the efficacy of low molecular weight heparin (LMWH) compared to unfractionated heparin (UFH) in preventing radial artery occlusion (RAO) and associated problems during trans-radial access (TRA) for coronary angiography.

In this moderate sized clinical prospective study conducted from March 2019 to January 2020 at Al Azhar Assiut University Hospital and Sohag Cardiac and GIT Center, 400 patients undergoing elective coronary angiography via TRA were divided into two groups. Group A (n = 200) received UFH, and Group B (n = 200) received LMWH (enoxaparin). Parameters assessed included radial artery diameter, flow volume, intima-media thickness (IMT), and complications post-procedure.

Except for gender distribution, no significant differences at baseline were identified between the groups. Although both groups showed slight changes in arterial diameter and flow volume with a small rise in IMT after 10 days, there were notable differences in radial artery occlusion rates. The UFH group had an occlusion rate of 3.5%, while the LMWH group had a rate of 0.5% (P = 0.032). The groups exhibited no significant difference in other consequences, such as hematoma and arteriovenous fistula.

LMWH (enoxaparin) administration via the radial sheath during TRA is a safe and effective strategy for reducing the incidence of RAO compared with UFH without increasing other procedural complications. This suggests that LMWH may be preferred for patients undergoing TRA for coronary angiography to minimize the risk of RAO.