Incidence and clinical course of limb dysfunction post cardiac catheterization: a systematic review

Ayyaz Ul Haq, Muhammad; Rashid, Muhammad; Gilchrist, Ian C.; Bertrand, Olivier; Shing Kwok, Chun; Wai Wong, Chun; Mansour, Hossam M.; Baghdaddy, Yasser; Nolan, James; van Leeuwen, Maarten A.H.; Mamas, Mamas A.

Abstract

Background

We sought to systematically review the available literature on limb dysfunction after transradial or transfemoral cardiac catheterization.

Methods & Results
MEDLINE and EMBASE were searched for studies evaluating any transradial or transfemoral procedures and limb function outcomes. Data was extracted, results were narratively synthesized with similar treatment arms. 15 studies with 3616 participants were included in transradial access (TRA) group. 3 studies reported nerve damage with a combined incidence of 0.16%, 4 studies reported sensory loss, tingling and numbness with a pooled incidence of 1.61%. Pain after TRA was the most common form of limb dysfunction (7.77%) reported in 3 studies. The incidence of hand dysfunction defined as disability, grip strength change, power loss or neuropathy was low at 0.49%. Although RAO was not a primary end point for this review, it was observed in 3.57% of the participants in a total of 8 studies included.4 studies with 15,903,894 participants were included in the transfemoral access (TFA) group. Rate of peripheral neuropathy was observed at 0.004%, sensory neuropathy due to local groin injury and retroperitoneal haematomas was 0.04% and 0.17% respectively, whereas motor deficit due to femoral and obturator nerve damage was 0.13%.

Conclusions
Limb dysfunction post cardiac catheterization is rare, patients may have nonspecific sensory and motor complaints that resolve over a period of time.

Citation

Ayyaz Ul Haq, M., Rashid, M., Gilchrist, I. C., Bertrand, O., Shing Kwok, C., Wai Wong, C., …Mamas, M. A. (2018). Incidence and clinical course of limb dysfunction post cardiac catheterization: a systematic review. Circulation Journal, 82(11), 2736. https://doi.org/10.1253/circj.CJ-18-0389

• Journal Article Type: Article
• Acceptance Date: Aug 1, 2018
• Publication Date: Nov 1, 2018
• Journal: Circulation Journal
• Print ISSN: 1346-9843
• Publisher: The Japanese Circulation Society
• Peer Reviewed: Peer Reviewed
• Volume: 82
• Issue: 11
• Pages: 2736
• DOI: https://doi.org/10.1253/circj.CJ-18-0389
• Keywords: hand dysfunction, leg dysfunction, distal extremity function, cardiac catheterization
• Publisher URL: http://doi.org/10.1253/circj.CJ-18-0389