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  • Title: Incidence and predictors of radial artery occlusion after transradial coronary angioplasty: Doppler-guided follow-up study.
    Author: Garg N, Madan BK, Khanna R, Sinha A, Kapoor A, Tewari S, Kumar S, Goel PK.
    Journal: J Invasive Cardiol; 2015 Feb; 27(2):106-12. PubMed ID: 25661763.
    Abstract:
    OBJECTIVES: To evaluate the incidence and predictors of radial artery occlusion (RAO) after transradial coronary angioplasty (TRA). BACKGROUND: RAO can occur after TRA but has not been well studied by serial vascular Doppler examination. METHODS: A total of 198 patients undergoing TRA were included. Radial pulse and Doppler examination of the radial artery were performed 1 day before, 1 day after, and 3 months after the procedure. RAO was defined as an absence of antegrade flow on Doppler studies. Logistic regression analysis was done to evaluate the predictors of RAO. RESULTS: The mean radial arterial diameter was 2.8 ± 0.4 mm. On the day after TRA, radial artery Doppler examination revealed RAO in 30 patients (15.2%). Radial pulse was still palpable in 30.0% of these patients. All of them were asymptomatic. At 3-month follow-up, no new RAO was noted. Interestingly, the radial artery had spontaneously recanalized in 8 patients (26.7%) with RAO. Patients with persistent RAO remained asymptomatic. On univariate analysis, female sex, diabetes, lower body mass index, radial artery diameter ≤2.5 mm, lower peak systolic velocity, and radial artery to sheath ratio <1 were predictors of RAO. Interestingly, procedural characteristics and duration of the procedure were not identified as predictors of RAO. On multivariate analysis, radial artery diameter ≤2.5 mm and preprocedural peak systolic velocity emerged as independent predictors for RAO. CONCLUSION: Asymptomatic RAO occurs in about 15% of patients after TRA. Spontaneous recanalization occurs in about one-fourth of these patients. Preprocedure radial artery inner diameter ≤2.5 mm and peak systolic velocity are the independent predictors of RAO.
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