Influence of Puncture Site on Radial Artery Occlusion After Transradial Coronary Intervention

Xi-Le Bi, Xiang-Hua Fu, Xin-Shun Gu, Yan-Bo Wang, Wei Li, Li-Ye Wei, Yan-Ming Fan, Shi-Ru Bai, Xi-Le Bi, Xiang-Hua Fu, Xin-Shun Gu, Yan-Bo Wang, Wei Li, Li-Ye Wei, Yan-Ming Fan, Shi-Ru Bai

Abstract

Background: The risk of radial artery occlusion (RAO) needs particular attention in transradial intervention (TRI). Therefore, reducing vascular occlusion has an important clinical significance. The aim of this study was to determine the appropriate puncture site during TRI through comparing the occurrence of RAO between the different puncture sites to reduce the occurrence of RAO after TRI.

Methods: We prospectively assessed the occurrence of RAO in 606 consecutive patients undergoing TRI. Artery occlusion was evaluated with Doppler ultrasound in 2 days and 1 year after the intervention. Risk factors for RAO were evaluated using a multivariate model analysis.

Results: Of the 606 patients, the RAO occurred in 56 patients. Compared with TRI at 2-5 cm away from the radius styloid process, the odds ratio (OR) for occlusion risk at 0 cm and 1 cm were 9.65 (P = 0.033) and 8.90 (P = 0.040), respectively. The RAO occurred in the ratio of the arterial diameter to the sheath diameter ≤1 (OR = 2.45, P = 0.004).

Conclusion: Distal puncture sites (0-1 cm away from the radius styloid process) can lead to a higher rate of RAO.

Trial registration: ClinicalTrials.gov, NCT01979627; https://ichgcp.net/clinical-trials-registry/NCT01979627?term = NCT01979627 and rank = 1.

Figures

Figure 1
Figure 1
Study flow chart. TRI: Transradial intervention.
Figure 2
Figure 2
Frequency of TRI puncture site use distribution of frequency in radial access puncture site use during TRI by 606 puncture sites. TRI: Transradial intervention.
Figure 3
Figure 3
(a) Distribution of the radial artery diameter. (b) Distribution of the radial artery depth. The diameter and depth at 0–5 cm from the styloid process were measured by Doppler ultrasound preoperatively.
Figure 4
Figure 4
Forest plot of RAO by risk factors. Puncture site: Defined as the distance from the radius styloid process to the puncture site; Diameter/sheath: The ratio of the arterial diameter to the sheath. RAO: Radial artery occlusion; OR: Odds ratio; CI: Confidence interval; BMI: Body mass index.
Figure 5
Figure 5
Predictors of the radial artery occlusion by multivariate analysis. Puncture site: Defined as the distance from the radial styloid process to puncture site; Diameter/sheath: The ratio of the arterial diameter to the sheath. OR: Odds ratio; CI: Confidence interval.

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