Arterial Injury During Radial Percutaneous Coronary Intervention
Compared to the transfemoral (TF) route, percutaneous cardiac procedures performed via a transradial (TR) approach are associated with significantly lower morbidity and are more cost-effective. Despite these practical advantages, TR procedures may be associated with vascular injuries and complications. The common complications encountered are RA spasm and RA occlusion. Rarely perforation or dissection of the RA, pseudoaneurysm, arteriovenous fistula formation and compartment syndrome can occur. Although all of these complications have been reported they are infrequent with the TR approach. Most of these are preventable with good patient preparation and optimal radial technique. When complications do occur they are usually not life or limb threatening and can be managed conservatively.
KeywordsRadial injuries Radial complications Access site complications
- 3.Bertrand OF, De Larochellière R, Rodés-Cabau J, Proulx G, Gleeton O, Nguyen CM, et al. Early discharge after transradial stenting of coronary arteries study investigators. A randomized study comparing same-day home discharge and abciximab bolus only to overnight hospitalization and abciximab bolus and infusion after transradial coronary stent implantation. Circulation. 2006;114:2636–43.CrossRefPubMedGoogle Scholar
- 5.Rathore S, Stables RH, Pauriah M, Hakeem A, Mills JD, Palmer ND, Perry RA, Morris JL. Impact of length and hydrophilic coating of the introducer sheath on radial artery spasm during transradial coronary intervention: a randomized study. JACC Cardiovasc Interv. 2010;3:475–83.CrossRefPubMedGoogle Scholar
- 15.Uhlemann M, Möbius-Winkler S, Mende M, Eitel I, Fuernau G, Sandri M, Adams V, Thiele H, Linke A, Schuler G, Gielen S. The Leipzig prospective vascular ultrasound registry in radial artery catheterization: impact of sheath size on vascular complications. JACC Cardiovasc Interv. 2012;5:36–43.CrossRefPubMedGoogle Scholar
- 16.Pancholy S, Coppola J, Patel T, Roke-Thomas M. Prevention of radial artery occlusion-patent hemostasis evaluation trial (PROPHET study): a randomized comparison of traditional versus patency documented hemostasis after transradial catheterization. Catheter Cardiovasc Interv. 2008;72:335–40.CrossRefPubMedGoogle Scholar