Palmar Arch Insufficiency as a Risk Factor for Radial Artery Occlusion After Transradial Catheterization (PAIRAO)
Palmar Arch Insufficiency as a Risk Factor for Radial Artery Occlusion After Transradial Catheterization - a Single-Centre Observational Study
Transradial access (TRA) is commonly used in different medical fields due to the superficial position of the radial artery and related advantages. Despite its popularity, the incidence and importance of related complications, in particular, radial artery occlusion (RAO) remains unclear. Further, the only known independent predictors of the radial artery occlusion are the periprocedural anticoagulation as well as the catheter size. The effect of a variable arterial anatomy has so far not been evaluated.
In this context, most institutions prefer to evaluate the collateral circulation of the hand, i.e., the arterial palmar arch and forearm circulation before TRA. The most commonly employed tests are the modified Allen test (MAT) or the combination of pulse oximetry and plethysmography according to Barbeau.In addition, there are more precise, but still semi-quantitative non-invasive methods for palmar arterial collateral function testing.
Despite the wealth of these variably accurate and practical tests, invasive and direct hemodynamic measurement of the arterial forearm circulation and its components is lacking. Thus, the human physiologic circulatory reference at this site has been unknown so far. Further, the need of pre-procedural testing itself can be questioned in light of the reported, widely varying prevalence of RAO (1-38%) or critical ischemia (0-0.09%) after TRA.
The present study investigated in a first step the invasively obtained, pressure-derived hemodynamic function, i.e., the physiology of the human arterial palmar arch and forearm collateral circulation and in a second step the clinical consequences of the variable palmar arterial anatomy.
研究概览
地位
条件
研究类型
注册 (实际的)
联系人和位置
学习地点
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Bern、瑞士、3010
- University Hospital Inselspital, Bern
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参与标准
资格标准
适合学习的年龄
接受健康志愿者
有资格学习的性别
取样方法
研究人群
描述
Inclusion Criteria:
- Age > 18 years
- Patient receiving transradial coronary angiography and undergoing evaluation of the palmar arterial arch circulation as a quality control
- Written informed consent to participate in the follow-up Doppler ultrasound examination
Exclusion Criteria:
- Changed anatomical conditions of the radial artery, e.g. after coronary artery bypass surgery with radial harvest
学习计划
研究是如何设计的?
设计细节
队列和干预
团体/队列 |
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Normal modified Allen Test
Patients undergoing transradial coronary angiography with a modified Allen-Test ≤ 15 seconds
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Abnormal modified Allen Test
Patients undergoing transradial coronary angiography with a modified Allen-Test > 15 seconds
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研究衡量的是什么?
主要结果指标
结果测量 |
措施说明 |
大体时间 |
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Radial artery occlusion
大体时间:3 months after transradial coronary angiography
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Frequency of radial artery occlusion after transradial coronary angiography; assessed by Doppler ultrasound measurements
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3 months after transradial coronary angiography
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次要结果测量
结果测量 |
措施说明 |
大体时间 |
---|---|---|
Palmar arch collateral circulation
大体时间:Measured during transradial access of the coronary angiography, expected to be 1 minute after local anesthesia and direct after successful punctuation of the radial artery
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Quantitatively measure of the pressure-derived function of the palmar collateral circulation during transradial catheterization.
Assessment of the collateral function by setting the invasively obtained blood pressure during external occlusion in relation to the unaffected blood pressure of the radial artery.
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Measured during transradial access of the coronary angiography, expected to be 1 minute after local anesthesia and direct after successful punctuation of the radial artery
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Radial artery stenosis
大体时间:3 months after transradial coronary angiography
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Frequency of radial artery stenosis after transradial coronary angiography; assessed by Doppler ultrasound measurements
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3 months after transradial coronary angiography
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合作者和调查者
出版物和有用的链接
研究记录日期
研究主要日期
学习开始 (实际的)
初级完成 (实际的)
研究完成 (实际的)
研究注册日期
首次提交
首先提交符合 QC 标准的
首次发布 (实际的)
研究记录更新
最后更新发布 (实际的)
上次提交的符合 QC 标准的更新
最后验证
更多信息
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