34. Radial artery ultrasound preceding transradial coronary angiography

• Main Authors: Rami Abazid, Osama A. Smettei, Haitham Saker, Sawsan Sayed, Mohamed Z. Mohamed, Mobadah Kattea, Annie Suresh, Yaser Bashir
• Format: Article
• Language: English
• Published: Saudi Heart Association 2015-10-01
• Series: Journal of the Saudi Heart Association
• Online Access: http://www.sciencedirect.com/science/article/pii/S1016731515002742

Transradial approaches (TRA) became the preferred vascular access during conventional coronary angiography (CCA). In fact a smaller mean radial artery diameter (RAD) may lead to higher rates of vascular access complications (VAC); however, there are no data regarding the effect of radial cross sectional area (CSA) and perimeter. We therefore evaluated the impact of preprocedure radial artery diameter, CSA and perimeter on vascular complications. Methods: We conducted a single-center prospective analysis of 207 patients underwent CCA. A radial artery ultrasound performed pre and post CCA to measure RAD, CSA, and perimeter. Results: The average RAD, CSA and perimeter were (2.7  ±  0.55 mm), (6.3  ±  1.9 mm2), (9.2  ±  1.7 mm) respectively. The same measurements were significantly larger in men than in women (2.8  ±  0.5 vs. 2.3  ±  0.4 mm [P < 0.0001], 6.7  ±  1.8 vs. 4.9  ±  1.4 mm [P <  0.0001], and 9.6  ±  1.5 vs. 9  ±  1.7 mm [P =  0.001], respectively). Fourteen patients (6.8%) had VACs. The RAD, CSA and perimeter were significantly smaller in procedures with VACs than in procedure with no complications (2.1 ± 0.5 vs. 2.7 ± 0.5 [P =  0.014], 4.6 ± 1.4 vs. 9.4 ± 1.6 [P =  0.014], and 7.2 ± 1.8 vs. 9.4 ± 1.6 [P =  0.022], respectively). Univariate logistic regression showed that radial ultrasonic parameters can independently predict VACs as follows: RAD (Odds ratio (OR) = 1.4. 95% CI 1.08–1.68, p = 007) for RAD, (OR = 2. 26. 95% CI 1.11–4.58, p = 0. 24) For CSA and (OR = 2.86. 95% CI 1.3–6, p = 0. 006) for perimeter. Summary: ultrasonic study of the radial artery before CCA can provide important information regarding the vascular access. We found that a smaller radial diameter, CSA and perimeter are associated with higher rates of VACs.