Evaluation of Peripheral Vascular Function After Distal Radial Artery Access for Invasive Percutaneous Coronary Procedures

Claudiu Ungureanu; Silviu Dumitrascu; Giuseppe Colletti; Marc Blaimont; Manuel Mignon; Philippe van de Borne

doi:10.2478/rjc-2022-0028

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Evaluation of Peripheral Vascular Function After Distal Radial Artery Access for Invasive Percutaneous Coronary Procedures

Romanian Journal of Cardiology

Volume 33 (2023): Issue 1 (March 2023)

By: Claudiu Ungureanu, Silviu Dumitrascu, Giuseppe Colletti, Marc Blaimont, Manuel Mignon and Philippe van de Borne

Open Access

|Mar 2023

Abstract

Objective: The aim of this study is to investigate the difference in impact between distal transradial access (dTRA) and classical transradial access (TRA) on vascular function using flow-mediated vasodilation (FMD) following coronary diagnostic and therapeutic catheterizations.

Methods: The analysis involves a non-randomized inclusion of patients undergoing either diagnostic or elective percutaneous coronary intervention, using a dTRA access or a conventional standard TRA. Two hours after the procedure ended, the endothelium-dependent flow-mediated dilation of the brachial artery was measured by ultrasound.

Results: A total number of 50 patients were included. There was no statistically significant difference between the two groups (7.20% vs 6.99%, p < 0.09 for non-inferiority). Additionally, there were higher baseline values observed for BA diameters in the conventional approach group.

Regarding the other secondary endpoints, there were no major access site complications, radial occlusion, in-hospital major bleeding or severe arterial spasm recorded in both groups.

Conclusion: Compared to conventional TRA, accessing distal radial artery for diagnostic and therapeutic coronary interventions has the same impact on short-term vascular endothelial function and was safely performed without any major vascular complications.

References

Andò G, Capodanno D, Radial access reduces mortality in patients with acute coronary syndromes. JACC Cardiovasc Interv. 2016; 9:660–670.
Search in Google Scholar Back to article
Ferrante G, Rao SV, Jüni P, Da Costa BR, Reimers B, Condorelli G et al. Radial versus femoral access for coronary interventions across the entire spectrum of patients with coronary artery disease. JACC Cardiovasc Interv. 2016; 9:1419–1434.
Search in Google Scholar Back to article
Neumann FJ, Sousa-Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U et al. 2018. ESC/EACTS Guidelines on myocardial revascularization. EHJ. 2019; 40:87–165.
Search in Google Scholar Back to article
Kristic I, Lukenda J. Radial artery spasm during transradial coronary procedures. J Invasive Cardiol. 2011; 23(12):527–531.
Search in Google Scholar Back to article
Di Serafino L, Barbato E, et al. Influence of transradial versus transfemoral diagnostic heart catheterisation on peripheral vascular endothelial function. EuroIntervention. 2013; 8:1252-1258.
Search in Google Scholar Back to article
Heiss C, Lauer T, et al. Vascular dysfunction of brachial artery After transradial access for coronary catheterization. JACC Cardiovascular Interventions. 2009; 2,11.
Search in Google Scholar Back to article
Sgueglia G, Babunashvili A, et al. Anatomic basis and physiological rationale of distal radial artery access for percutaneous coronary and endovascular procedures. JACC Cardiovascular Interventions. 2018; 11, 20.
Search in Google Scholar Back to article
Gasparini GL, Garbo R, Gagnor A, Oreglia J, and Mazzarotto P. First prospective multicentre experience with left distal transradial approach for coronary chronic total occlusion interventions using a 7 Fr Glidesheath Slender. EuroIntervention. 2019; 15:126–128.
Search in Google Scholar Back to article
Colletti G, Ungureanu C, et al. Feasibility and safety of performing complex coronary interventions by distal radial artery using the Railway Sheathless Vascular System. Invasive Cardiol. 2020; October 10.
Search in Google Scholar Back to article
van der Heijden DJ, van Royen N, et al. The impact on radial injury of sheathless versus conventional access for transradial interventions: a randomized trial. EuroIntervention. 2019; 675.
Search in Google Scholar Back to article
Corretti MC, Anderson TJ, Benjamin EJ, Celermajer D, Charbonneau F, Creager MA, Deanfield J, Drexler H, Gerhard-Herman M, Herrington D, et al. Guidelines for the ultrasound assessment of endothelial-dependent flow-mediated vasodilation of the brachial artery: A report of the international brachial artery reactivity task force. J Am Coll Cardiol. 2002; 39(2): 257–65.
Search in Google Scholar Back to article
Dharma S, Kedev S, Patel T, Gilchrist I, Radao S. The predictors of post-procedural arm pain after transradial approach in 1706 patients underwent transradial catheterization. Cardiovasc Revasc Med. 2019; 20(8): 674–677.
Search in Google Scholar Back to article
Zwaan E, Isselmuiden A, van Rosmalen J, et al. Rationale and design of the ARCUS: effects of trAnsRadial perCUtaneouS coronary intervention on upper extremity function. Catheter Cardiovasc Interv 2016; 88: 1036–1043.
Search in Google Scholar Back to article
Klocker J, Peter T, Pellegrini L, et al. Incidence and predisposing factors of cold intolerance after arterial repair in upper extremity injuries. J Vasc Surg. 2012; 25: 410–414.
Search in Google Scholar Back to article
Kotowycz M, Dzavik V. Radial artery patency after transradial catheterization. Circ Cardiovasc Interv. 2012; 5: 127–133.
Search in Google Scholar Back to article
Harris RA, Nishiyama SK, Wray DW, Richardson RS. Ultrasound assessment of flow-mediated dilation. Hypertension. 2010 May; 55(5): 1075–85. Epub 2010 Mar 29. PMID: 20351340.
Search in Google Scholar Back to article
Heiss C, Balzer J, Hauffe T, Hamada S, Stegemann E, Koeppel T, Merx MW, Rassaf T, Kelm M, Lauer T. Vascular dysfunction of brachial artery after transradial access for coronary catheterization: Impact of smoking and catheter changes. JACC Cardiovasc Interv. 2009 Nov; 2(11): 1067–73.
Search in Google Scholar Back to article
Ichijo S, Yonetsu T, Murai T, Kanaji Y, Usui E, Hoshino M, Yamaguchi M, Hada M, Hamaya R, Kanno Y, Kakuta T. Impact of transradial catheterization on vascular function of the brachial artery assessed by flow-mediated dilatation. Acta Cardiol Sin. 2019 Mar; 35(2): 126–133.
Search in Google Scholar Back to article

Articles in this issue

DOI: https://doi.org/10.2478/rjc-2022-0028 | Journal eISSN: 2734-6382 | Journal ISSN: 1220-658X

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Language: English

Page range: 14 - 18

Published on: Mar 18, 2023

Published by: Romanian Society of Cardiology

In partnership with: Paradigm Publishing Services

Publication frequency: 4 issues per year

Keywords:

flow-mediated vasodilation,

vascular dysfunction,

distal radial artery,

complex coronary interventions,

Related subjects:

Surgery,

Pediatrics and juvenile medicine,

Paediatric cardiology

© 2023 Claudiu Ungureanu, Silviu Dumitrascu, Giuseppe Colletti, Marc Blaimont, Manuel Mignon, Philippe van de Borne, published by Romanian Society of Cardiology
This work is licensed under the Creative Commons Attribution 4.0 License.

Volume 33 (2023): Issue 1 (March 2023)