Radial Artery Anomalies and Subsequent Impact on Transradial Coronary Procedures—A Single Centre Experience

Abstract

Background: Wollongong Hospital is a regional tertiary referral centre in NSW. A transradial approach for coronary angiography and intervention was commenced in March 2010. The transradial approach has a number of significant advantages over the femoral approach; however various technical challenges have impeded its utilisation. Some of these challenges relate to radial artery anatomy. Our aim is evaluate the incidence and influence of radial artery anomalies with regards to transradial procedures. Methods: Data related to baseline characteristics, procedure variables, radial artery anatomy and procedure outcome were collected on patients due to have retrograde radial arteriography performed between June 2011 and March 2012. Results: 135 patients were included in this study. Mean age was 67.05 years, M:F (75:60). In total 128 patients underwent retrograde arteriography (seven arteries unable to be viewed). The incidence of radial artery anomaly was 13/128 (10%). Anomalies identified were tortuous arteries (n = 5, 4%), loops (n = 4, 3%) and high bifurcations (n = 4, 3%). Overall success was 121/135 (89.6%). The success rate in patients with normal radial anatomy was 110/115 (95.6%) and in those with anomalies 11/13 (84.6%). The breakdown of success rate was 80% (4/5) in tortuous arteries and 75% (3/4) in both high bifurcations and loops. Of note the failure in the high bifurcation artery was due to spasm. Conclusion: Our study shows that radial artery anomalies are relatively common and the success rate of coronary procedures is also lower in these patients. The use of retrograde radial angiography can help operators evaluate radial artery anatomy and devise strategies to improve success rate.