Prevalence and Predictors of Trans Radial Approach Complications in Coronary Angiography and Percutaneous Coronary Intervention

Abstract

Abstract Background An increasingly popular approach for both diagnostic and interventional coronary procedures is the transradial approach (TRA). When compared to a transfemoral approach (TFA), (TRA)was found to lessen vascular complications. The most frequent and commonly silent transradial approach (TRA) complication is radial artery occlusion (RAO), which is followed by less serious vascular complications including hematoma and radial artery spasm. Aim and Objectives Evaluate the prevalence and predictors of complications of transradial approach (TRA) immediately after TR procedure and follow-up by radial artery doppler ultrasonography within 24 hours. Subjects and Methods This prospective registry observational study involved 250 patients who underwent either diagnostic coronary angiography, elective PCI, or primary PCI by TRA. It was carried out at Ain Shams University Hospitals and October 6 University Hospital. Result RAO, affected 20% of patients who underwent a TR procedure, which was the most frequent complication, followed by hematomas and spasms, each affected 8% of patients. It is noteworthy that none of the patients experienced hemorrhage, pseudoaneurysms, or AV fistula. Univariate and multivariate regression analysis revealed that, factors independently associated with TRA complications were patients in the age group (≥ 60 years old) (OR = 19.33, 95%CI: 9.09 to 41.11, P < 0.001) and female patients (OR = 2.67, 95%CI: 1.56 to 4.55, P < 0.001), and according to the periprocedural factors to be wrap closure by rolled gauze (OR = 15.17, 95%CI: 8.03 to 28.65, P < 0.001) and delayed time of compression release (OR = 2.97, 95%CI: 2.07 to 4.26, P < 0.001). Conclusion Older patients, female patients, lower BMI, longer procedure duration, more number of catheters used, wrap closure with rolled gauze, and delayed time of compression were the predictors of transradial approach (TRA) complications immediately following TR procedure and in the follow-up by radial artery Doppler ultrasonography within 24 hours. RAO, which affected 20% of patients who underwent a TR procedure, was the most frequent complication, followed by hematomas and spasms, each affected 8% of patients. It is noteworthy that none of the patients experienced hemorrhage, pseudoaneurysms, or AV fistula.