Radial artery anomalies in the Macedonian population during transradial angiography procedures

Biljana Zafirovska,Hajber Taravari,Oliver Kalpak,Sasko Kedev,Danica Petkoska,Marjan Bosev,Aleksandar Jovkovski,Jorgo Kostov,Igor Spiroski,Ivan Vasilev,Hristo Pejkov,Darko Kitanoski,Slobodan Antov

doi:10.5937/sanamed1602087z

Abstract

Objective: To assess the incidence of arterial anomalies of the radial artery in the Macedonian population registered during transradial access (TRA) angiography procedures in a large series of patients. Background: Transradial angiography (TRA) is now the recommended access for percutaneous coronary intervention, but technically is a more challenging approach for angiography procedures mostly due to the anatomic anomalies on the radial artery, which may influence the success rate of transradial angiographic procedures. Methods: All consecutive 19292 patients from our Center, in the period from March 2011 until December 2014 were examined. Preprocedural radial artery angiography was performed in all patients. Clinical and procedure characteristics, type and incidence of vascular anatomy variants and access site complications were analyzed. Results: Anatomical variants were present in 1625 (8.8%) patients. The most frequent was high-bifurcating radial artery origin from the axillary and brachial arteries in 1017 (5.5%) patients, 227 (1.2%) had extreme radial artery tortuosity, 176 (0.95%) had a full radial loop, 32 (0.17%) with hypoplastic radial artery and 173 (0.9%) had tortuous brachial, subclavian and axillary arteries. Radial artery spasm was very common in patients with present radial artery anomalies. Conclusion: Radial artery anomalies are very common in the general population. Knowing the anatomy of the radial artery helps the interventional cardiologist in successfully planning and performing this procedure. Radial artery angiography is strongly encouraged in every patient before the begining of the transradial angiography procedures.

Highlights

Trans radial access (TRA) is the preferred access site for percutaneous cardiovascular interventions in experienced radial centers [1].Radial artery anomalies are frequently found in the general population
Radial artery anomalies are very common in the general population
Radial artery angiography is strongly encouraged in every patient before the begining of the transradial angiography procedures

Summary

Introduction

Trans radial access (TRA) is the preferred access site for percutaneous cardiovascular interventions in experienced radial centers [1].Radial artery anomalies are frequently found in the general population. Multiple studies support transfer from femoral artery access to radial access for all angiographic diagnostic and interventional procedures mostly due to decreasing access site bleeding and vascular complications without sacrificing procedural success [10, 11, 12, 13]. Patients with increased risk of bleeding and vascular complications have a particular benefit from TRA as opposed to transfemoral approach (TFA): female gender, elderly, obesity, low weight, hypertension, renal failure, low platelet count and anemia [10, 11, 12, 13]. Transradial angiography (TRA) is the recommended access for percutaneous coronary intervention, but technically is a more challenging approach for angiography procedures mostly due to the anatomic anomalies on the radial artery, which may influence the success rate of transradial angiographic procedures

Methods

Results

Discussion

Conclusion