Radial artery occlusion after transradial interventions: a systematic review and meta-analysis

Rashid, Muhammad; Shing Kwok, Chun; Pancholy, Samir; Chugh, Sanjay; Kedev, Sasko A.; Bernat, Ivo; Ratib, Karim; Large, Adrian; Fraser, Doug; Nolan, James; Mamas, Mamas

Abstract

Abstract Objectives: To investigate the incidence and factors influencing radial artery occlusion (RAO) post trans-radial access (TRA) for cardiac catheterization. Background: RAO may occur post trans-radial intervention and limits the radial artery as a future access site and precludes its use as an arterial conduit. In this study, we investigate the incidence and factors influencing the RAO in the current literature. Methods & Results: We searched MEDLINE and EMBASE for studies of RAO in TRA. Relevant studies were identified and data was extracted. Data was synthesized by meta-analysis, quantitative pooling, graphical representation or by narrative synthesis. A total of 66 studies with 31,345 participants were included in the analysis. Incident RAO ranged between <1% to 33% and varied with timing of assessment of radial artery patency (incidence of RAO within 24 hours was 7.7% which decreased to 5.5% at greater than 1 week follow up). The most efficacious measure in reducing RAO was higher dose of heparin as lower doses of heparin were associated with increased RAO (RR 0.36, 95%CI 0.17-0.76) whilst shorter compression times also reduced RAO (RR 0.28, 95%CI 0.05-1.50). Several factors were found to be associated with RAO including age, gender, sheath size and diameter of radial artery but these factors were not consistent across all studies. Conclusions: RAO is a common complication of TRA. Maintenance of radial patency should be an integral part of all procedures undertaken through the radial approach. High dose heparin along with shorter compression times and patent hemostasis is recommended in reducing radial artery occlusion.

Citation

Rashid, M., Shing Kwok, C., Pancholy, S., Chugh, S., Kedev, S. A., Bernat, I., Ratib, K., Large, A., Fraser, D., Nolan, J., & Mamas, M. (2016). Radial artery occlusion after transradial interventions: a systematic review and meta-analysis. Journal of the American Heart Association Cardiovascular and Cerebrovascular Disease, 51(1), https://doi.org/10.1161/JAHA.115.002686

• Journal Article Type: Article
• Acceptance Date: Nov 23, 2015
• Online Publication Date: Jan 25, 2016
• Publication Date: Jan 13, 2016
• Publicly Available Date: May 26, 2023
• Journal: Journal of American Heart Association
• Print ISSN: 2047-9980
• Electronic ISSN: 2047-9980
• Publisher: Wiley Open Access
• Peer Reviewed: Peer Reviewed
• Volume: 51
• Issue: 1
• DOI: https://doi.org/10.1161/JAHA.115.002686
• Keywords: radial artery occlusion, transradial catheterization or access, vascular complications
• Public URL: https://keele-repository.worktribe.com/output/405084
• Publisher URL: http://jaha.ahajournals.org/