Factors Affecting Radial Artery Occlusion After Right Transradial Artery Catheterization for Coronary Intervention and Procedures.

IF 2.3 3区医学 Q2 HEALTH CARE SCIENCES & SERVICES

Therapeutics and Clinical Risk Management Pub Date : 2023-06-24 eCollection Date: 2023-01-01 DOI:10.2147/TCRM.S403410

Dujuan Xu, Ying Liu, Chao Xu, Xuekui Liu, Ye Chen, Chunguang Feng, Nan Lyu

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Abstract

Objective: To determine the factors influencing proximal radial artery occlusion (PRAO) right radial artery after coronary intervention.

Methods: This is a single-center prospective observational study. A total of 460 patients were selected to undergo coronary angiography (CAG) or percutaneous coronary intervention (PCI) via the proximal transradial approach (PTRA) or distal transradial approach (DTRA). The 6F sheath tube were received by all patients. Radial artery ultrasound was performed 1 day before procedure and 1-4 days after procedure. Patients were divided into the PRAO group (42 cases) and the non-PRAO group (418 cases). General clinical data and preoperative radial artery ultrasound indexes of the two groups were compared to analyze related factors leading to PRAO.

Results: The total incidence of PRAO was 9.1%, including 3.8% for DTAR and 12.7% for PTRA. The PRAO rate of DTRA was significantly lower than that of PTRA (p < 0.05). Female, low body weight, low body mass index (BMI) and CAG patients were more likely to develop PRAO after procedure (p < 0.05). The internal diameter and cross-sectional area of the distal radial artery and proximal radial artery were smaller in the PRAO group than in the non-PRAO group, and the differences were statistically significant (p < 0.05). Multifactorial model analysis showed that the puncture approach, radial artery diameter and procedure type were predictive factors of PRAO, and the receiver operating characteristic curve showed a good predictive value.

Conclusion: A larger radial artery diameter and DTRA may reduce the incidence of PRAO. Preoperative radial artery ultrasound can guide the clinical selection of appropriate arterial sheath and puncture approach.

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右侧经桡动脉导管冠状动脉介入和手术后桡动脉闭塞的影响因素。

目的：确定冠状动脉介入治疗后右桡动脉近端闭塞（PRAO）的影响因素：确定冠状动脉介入治疗后右桡动脉近端闭塞（PRAO）的影响因素：这是一项单中心前瞻性观察研究。方法：这是一项单中心前瞻性观察研究，共选取了 460 名患者，通过近端经桡动脉入路（PTRA）或远端经桡动脉入路（DTRA）进行冠状动脉造影（CAG）或经皮冠状动脉介入治疗（PCI）。所有患者均接受了 6F 插管。术前 1 天和术后 1-4 天进行桡动脉超声检查。患者分为 PRAO 组（42 例）和非 PRAO 组（418 例）。比较两组患者的一般临床数据和术前桡动脉超声指标，分析导致 PRAO 的相关因素：结果：PRAO的总发生率为9.1%，其中DTAR为3.8%，PTRA为12.7%。DTRA 的 PRAO 率明显低于 PTRA（P < 0.05）。女性、低体重、低体重指数（BMI）和 CAG 患者术后更易发生 PRAO（P < 0.05）。PRAO 组桡动脉远端和桡动脉近端的内径和横截面积均小于非 PRAO 组，差异有统计学意义（P < 0.05）。多因素模型分析表明，穿刺方式、桡动脉直径和手术类型是 PRAO 的预测因素，接收者操作特征曲线显示了良好的预测价值：结论：较大的桡动脉直径和DTRA可降低PRAO的发生率。结论：较大的桡动脉直径和 DTRA 可降低 PRAO 的发生率，术前桡动脉超声检查可指导临床选择合适的动脉鞘和穿刺方法。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Therapeutics and Clinical Risk Management HEALTH CARE SCIENCES & SERVICES-

CiteScore

4.80

自引率

3.60%

发文量

139

审稿时长

16 weeks

期刊介绍： Therapeutics and Clinical Risk Management is an international, peer-reviewed journal of clinical therapeutics and risk management, focusing on concise rapid reporting of clinical studies in all therapeutic areas, outcomes, safety, and programs for the effective, safe, and sustained use of medicines, therapeutic and surgical interventions in all clinical areas. The journal welcomes submissions covering original research, clinical and epidemiological studies, reviews, guidelines, expert opinion and commentary. The journal will consider case reports but only if they make a valuable and original contribution to the literature. As of 18th March 2019, Therapeutics and Clinical Risk Management will no longer consider meta-analyses for publication. The journal does not accept study protocols, animal-based or cell line-based studies.