Advertisement

Heart and Vessels

, Volume 34, Issue 5, pp 771–776 | Cite as

Influence of remote ischemic conditioning on radial artery occlusion

  • Miao Liu
  • Qingzan Kong
  • Xiaojun Cai
  • Guohai SuEmail author
Original Article
  • 62 Downloads

Abstract

This study aimed to explore the influence of remote ischemic conditioning (RIC) on radial artery occlusion (RAO) and distinguish the risk factors for RAO. A total of 640 consecutive patients who prospectively underwent transradial artery coronary angiography (TRACA) (322 patients received RIC before TRACA) were enrolled. RIC was not performed in 318 patients. RAO was estimated using Doppler ultrasonography after the procedure. Patients were divided into two groups according to the protocol of RIC: RIC and non-RIC. The rate of RAO was significantly lower in the RIC group than in the non-RIC group. Patients were divided into two groups according to the patency of radial artery: radial artery patency (RAP) and RAO. The radial artery diameter was significantly narrower in the RAO group (2.31 ± 0.53) than in the RAP group (2.59 ± 0.47). The rate of applying β-blocker was significantly higher in the RAP group (69%) than in the RAO group (41%). The rate of applying trimetazidine was significantly higher in the RAP group (49.1%) than in the RAO group (17.6%). The multiple logistic regression analysis using radial artery diameter, RIC, β-blocker, and trimetazidine treatments revealed that small radial artery diameter, lack of β-blockers, and RIC were independent predictors of RAO. RIC might help in improving the rate of RAO. The multiple logistic regression analysis showed that the lack of β-blockers, RIC, and small radial artery diameter were independent predictors of RAO.

Keywords

Radial artery occlusion Remote ischemic conditioning Transradial artery coronary angiography 

Notes

Compliance with ethical standards

Conflict of interest

All the authors have no funding, financial relationships, or conflicts of interest to disclose.

References

  1. 1.
    Cruden NL, Teh CH, Starkey IR, Newby DE (2007) Reduced vascular complications and length of stay with transradial rescue angioplasty for acute myocardial infarction. Cathet Cardiovasc Interv 70:670–675CrossRefGoogle Scholar
  2. 2.
    Eichhöfer J, Horlick E, Ivanov J, Seidelin PH, Ross JR, Ing D, Daly P, Mackie K, Ridley B, Schwartz L, Barolet A, Dzavík V (2008) Decreased complication rates using the transradial compared to the transfemoral approach in percutaneous coronary intervention in the era of routine stenting and glycoprotein platelet IIb/IIIa inhibitor use: a large single-center experience. Am Heart J 156:864–870CrossRefGoogle Scholar
  3. 3.
    Jolly SS, Amlani S, Hamon M, Yusuf S, Mehta SR (2009) Radial versus femoral access for coronary angiography or intervention and the impact on major bleeding and ischemic events: a systematic review and meta-analysis of randomized trials. Am Heart J 157:132–140CrossRefGoogle Scholar
  4. 4.
    Jolly SS, Yusuf S, Cairns J, Niemelä K, Xavier D, Widimsky P, Budaj A, Niemelä M, Valentin V, Lewis BS, Avezum A, Steg PG, Rao SV, Gao P, Afzal R, Joyner CD, Chrolavicius S, Mehta SR (2011) RIVAL trial group. Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial. Lancet 377:1409–1420CrossRefGoogle Scholar
  5. 5.
    Mitchell MD, Hong JA, Lee BY, Umscheid CA, Bartsch SM, Don CW (2012) Systematic review and cost-benefit analysis of radial artery access for coronary angiography and intervention. Circ Cardiovasc Qual Outcomes 5:454–462CrossRefGoogle Scholar
  6. 6.
    Schueler A, Black SR, Shay NJ (2013) Management of transradial access for coronary angiography. J Cardiovasc Nurs 28:468–472CrossRefGoogle Scholar
  7. 7.
    Burstein JM, Gidrewicz D, Hutchison SJ, Holmes K, Jolly S, Cantor WJ (2007) Impact of radial artery cannulation for coronary angiography and angioplasty on radial artery function. Am J Cardiol 99:457–459CrossRefGoogle Scholar
  8. 8.
    Mamas MA, Fraser DG, Ratib K, Fath-Ordoubadi F, El-Omar M, Nolan J, Neyses L (2014) Minimising radial injury: prevention is better than cure. EuroIntervention 10:824–832CrossRefGoogle Scholar
  9. 9.
    Elbadawi A, Ha LD, Abuzaid AS, Crimi G, Azzouz MS (2017) Meta-analysis of randomized trials on remote ischemic conditioning during primary percutaneous coronary intervention in patients with ST-segment elevation myocardial infarction. Am J Cardiol 119:832–838CrossRefGoogle Scholar
  10. 10.
    Kanoria S, Robertson FP, Mehta NN, Fusai G, Sharma D, Davidson BR (2017) Effect of remote ischaemic preconditioning on liver injury in patients undergoing major hepatectomy for colorectal liver metastasis: a pilot randomised controlled feasibility trial. World J Surg 41:1322–1330CrossRefGoogle Scholar
  11. 11.
    Zhou X, Jiang R, Dong Y, Wang L (2017) Remote ischemic preconditioning attenuates cardiopulmonary bypass-induced lung injury. PLoS One 12:e0189501CrossRefGoogle Scholar
  12. 12.
    Balcı C, Akan M, Boztaş N, Özkardeşler S, Ergür BU, Güneli ME, Ünal B (2017) Protective effects of dexmedetomidine and remote ischemic preconditioning on renal ischemia reperfusion injury in rats. Ulus Travma Acil Cerrahi Derg 23:279–286Google Scholar
  13. 13.
    Shimizu M, Tropak M, Diaz RJ, Suto F, Surendra H, Kuzmin E, Li J, Gross G, Wilson GJ, Callahan J, Redington AN (2009) Transient limb ischaemia remotely preconditions through a humoral mechanism acting directly on the myocardium: evidence suggesting cross-species protection. Clin Sci (Lond) 117:191–200CrossRefGoogle Scholar
  14. 14.
    Lim SY, Yellon DM, Hausenloy DJ (2010) The neural and humoral pathways in remote limb ischemic preconditioning. Basic Res Cardiol 105:651–655CrossRefGoogle Scholar
  15. 15.
    Loukogeorgakis SP, Panagiotidou AT, Broadhead MW, Donald A, Deanfield JE, MacAllister RJ (2005) Remote ischemic preconditioning provides early and late protection against endothelial ischemia-reperfusion injury in humans: role of the autonomic nervous system. J Am Coll Cardiol 46:450–456CrossRefGoogle Scholar
  16. 16.
    Hamon M, Pristipino C, Di Mario C, Nolan J, Ludwig J, Tubaro M, Sabate M, Mauri-Ferré J, Huber K, Niemelä K, Haude M, Wijns W, Dudek D, Fajadet J, Kiemenei F, European Association of Percutaneous Cardiovascular Interventions, Working Group on Acute Cardiac Care of the European Society of Cardiology, Working Group on Thrombosis on the European Society of Cardiology (2013) Consensus document on the radial approach in percutaneous cardiovascular interventions: position paper by the European Association of Percutaneous Cardiovascular Interventions and Working Groups on acute cardiac care and thrombosis of the European Society of Cardiology. EuroIntervention 8:1242–1251Google Scholar
  17. 17.
    Kitagawa K, Saitoh M, Ishizuka K (2018) Remote limb ischemic conditioning during cerebral ischemia reduces infarct size through enhanced collateral circulation in murine focal cerebral ischemia. J Stroke Cerebrovasc Dis 27:831–838CrossRefGoogle Scholar
  18. 18.
    Manchurov V, Ryazankina N, Khmara T, Skrypnik D, Reztsov R, Vasilieva E, Shpektor A (2014) Remote ischemic preconditioning and endothelial function in patients with acute myocardial infarction and primary PCI. Am J Med 127:670–673CrossRefGoogle Scholar
  19. 19.
    Pedersen CM, Cruden NL, Schmidt MR, Lau C, Bøtker HE, Kharbanda RK, Newby DE (2011) Remote ischemic preconditioning prevents systemic platelet activation associated with ischemia-reperfusion injury in humans. J Thromb Haemost 9:404–407CrossRefGoogle Scholar
  20. 20.
    Shimizu M, Saxena P, Konstantinov IE, Cheung Cherepanov V, MM, Wearden P, Zhangdong H, Schmidt M, Downey GP, Redington AN, (2010) Remote ischemic preconditioning decreases adhesion and selectively modifies functional responses of human neutrophils. J Surg Res 158:155–161CrossRefGoogle Scholar
  21. 21.
    Konstantinov IE, Arab S, Kharbanda RK, Li J, Cheung MM, Cherepanov V, Downey GP, Liu PP, Cukerman E, Coles JG, Redington AN (2004) The remote ischemic preconditioning stimulus modifies inflammatory gene expression in humans. Physiol Genom 19:143–150CrossRefGoogle Scholar
  22. 22.
    Kharbanda RK, Mortensen UM, White PA, Kristiansen SB, Schmidt MR, Hoschtitzky JA, Vogel M, Sorensen K, Redington AN, MacAllister R (2002) Transient limb ischemia induces remote ischemic preconditioning in vivo. Circulation. 106:2881–2883CrossRefGoogle Scholar
  23. 23.
    Mamas M, D’Souza S, Hendry C, Ali R, Iles-Smith H, Palmer K, El-Omar M, Fath-Ordoubadi F, Neyses L, Fraser DG (2010) Use of the sheathless guide catheter during routine transradial percutaneous coronary intervention: a feasibility study. Cathet Cardiovasc Interv 75:596–602Google Scholar
  24. 24.
    Rashid M, Kwok CS, Pancholy S, Kedev SA, Bernat I, Ratib K, Large A, Fraser D, Nolan J, Mamas MA (2016) Radial artery occlusion after transradial interventions a systematic review and meta-analysis. J Am Heart Assoc 5:pii e002686CrossRefGoogle Scholar
  25. 25.
    Saito S, Ikei H, Hosokawa G, Tanaka S (1999) Influence of the ratio between radial artery inner diameter and sheath outer diameter on radial artery flow after transradial coronary intervention. Catheter Cardiovasc Inter 46:173–178CrossRefGoogle Scholar
  26. 26.
    Chugh S, Chugh Y (2015) Radial artery occlusion: size & more-how small is too small? J Invasive Cardiol 27:E113–E114Google Scholar
  27. 27.
    Chatterjee S, Biondi-Zoccai G, Abbate A, D'Ascenzo F, Castagno D, Van Tassell B, Mukherjee D, Lichstein E (2013) Benefits of β blockers in patients with heart failure and reduced ejection fraction: network meta-analysis. BMJ 346:f55CrossRefGoogle Scholar
  28. 28.
    Kantor PF, Lucien A, Kozak R, Lopaschuk GD (2000) The antianginal drug trimetazidine shifts cardiac energy metabolism from fatty acid oxidation to glucose oxidation by inhibiting mitochondrial long-chain 3-ketoacyl coenzyme A thiolase. Circ Res 86:580–588CrossRefGoogle Scholar
  29. 29.
    Belardinelli R, Solenghi M, Volpe L, Purcaro A (2007) Trimetazidine improves endothelial dysfunction in chronic heart failure: an antioxidant effect. Eur Heart J 28:1102–1108CrossRefGoogle Scholar
  30. 30.
    Faure JP, Baumert H, Han Z, Goujon JM, Favreau F, Dutheil D, Petit I, Barriere M, Tallineau C, Tillement JP, Carretier M, Mauco G, Papadopoulos V, Hauet T (2003) Evidence for a protective role of trimetazidine during cold ischemia: targeting inflammation and nephron mass. Biochem Pharmacol 66:2241–2250CrossRefGoogle Scholar
  31. 31.
    Park KH, Park WJ, Kim MK, Park DW, Park JH, Kim HS, Cho GY (2010) Effects of trimetazidine on endothelial dysfunction after sheath injury of radial artery. Am J Cardiol 105:1723–1727CrossRefGoogle Scholar
  32. 32.
    Liu X, Gai Y, Liu F, Gao W, Zhang Y, Xu M, Li Z (2010) Trimetazidine inhibits pressure overload-induced cardiac fibrosis through NADPH oxidase-ROS-CTGF pathway. Cardiovasc Res 88:150–158CrossRefGoogle Scholar
  33. 33.
    Gloire G, Piette J (2009) Redox regulation of nuclear post-translational modifications during NF-kappaB activation. Antioxid Redox Signal 11:2209–2222CrossRefGoogle Scholar
  34. 34.
    Loukogeorgakis SP, Williams R, Panagiotidou AT, Kolvekar SK, Donald A, Cole TJ, Yellon DM, Deanfield JE, MacAllister RJ (2007) Transient limb ischemia induces remote preconditioning and remote postconditioning in humans by a K(ATP)-channel dependent mechanism. Circulation 116:1386–1395CrossRefGoogle Scholar
  35. 35.
    Minamino T (2012) Cardioprotection from ischemia/reperfusion injury: basic and translational research. Circ J 76:1074–1082CrossRefGoogle Scholar
  36. 36.
    Honda T, Fujimoto K, Miyao Y, Koga H, Hirata Y (2012) Access site-related complications after transradial catheterization can be reduced with smaller sheath size and statins. Cardiovasc Interv Ther 27:174–180CrossRefGoogle Scholar

Copyright information

© Springer Japan KK, part of Springer Nature 2019

Authors and Affiliations

  • Miao Liu
    • 1
  • Qingzan Kong
    • 1
  • Xiaojun Cai
    • 1
  • Guohai Su
    • 1
    Email author
  1. 1.Department of CardiologyJinan Central Hospital Affiliated To Shandong UniversityJinanPeople’s Republic of China

Personalised recommendations