Abstract 18953: Prevalence of and Risk Factors for Radial Artery Complications After Transradial Cardiac Catheterization

Abstract

Background: In recent years, radial access for cardiac catheterization gains popularity. One of the most common complications is radial artery occlusion (RAO). There are various numbers for the prevalence of RAO in literature, ranging from 5 to 30% when using a 6F sheath. Our study was designed to investigate the prevalence of radial artery (RA) complications (RAO, false aneurysm, arteriovenous fistula) in a single center population using a 6F sheath. Methods: 415 patients* (pts) were examined clinically and with duplex sonography 4 - 68 weeks after cardiac catheterization (60.7% (n=254) male, median age 68 y (33 - 88). In n=103 pts (24.6%) an intervention had been performed immediately after the diagnostics. Results: Patient characteristics are summarized in table 1. RAO was found in 15/418 cases (3.6%, n = 10 female, n = 5 male). Of those 10 patients, 3 showed (transient) symptoms (dysaesthesia, feeling of heaviness of the hand), cases of critical ischaemia were not found. No false aneurysm was found, one pt showed an arteriovenous fistula in the proximal RA. One patient showed significant stenosis of the middle portion of the brachial artery in addition to RAO, another one showed a mild stenosis of the RA. Women showed a significantly higher rate of RAO (n = 10, 66.7% in the RAO group vs. n = 154, 40.3% in the comparison group, p = 0.03). Other risk factors seem to be diabetes (n = 6, 40% vs. n = 106, 26%) and renal insufficiency (n = 3, 20% vs. n = 43, 11%), although the risk was not significantly increased. Interestingly, a coronary intervention does not seem to increase the risk of RAO (n = 2, 13% vs. n = 101, 26%). Hypertension, dyslipidemia, present or past smoking, body height, age, and BMI did not have significant influence. Conclusion: Vascular complications, especially RAO, after radial access for cardiac catheterization are quite rare and remain usually asymptomatic. Women are at higher risk. Diabetic pts and pts with impaired renal function seem to be at slightly higher risk.