Radial artery ultrasound predicts the success of transradial coronary angiography.

Abstract

The transradial approach has become the preferred vascular access during conventional coronary angiography (CCA). Hereby, we evaluated the impact of pre-procedural radial artery diameter (RAD), the cross-sectional area (CSA), and the perimeter on vascular complications (VACs). We conducted a single-center prospective analysis of 513 patients who underwent CCA. Radial artery ultrasonography was performed before and after CCA to measure the RAD, CSA, and perimeter. The average RAD, CSA, and perimeter were 2.60 ± 0.48 mm, 6.2 ± 3.0 mm2, and 8.9 ± 1.7 mm, respectively. Vascular complications were reported in 56 (11%) patients. The RAD, CSA, and perimeter were significantly smaller in patients in whom procedure-related VACs were observed than in those with no complications: 2.3 ± 0.5 vs. 2.70 ± 0.54 mm (p = 0.0001), 4.9 ± 2.1 vs. 6.4 ± 3 mm2 (p = 0.001), and 7.6 ± 2.1 vs. 9.2 ± 1.6 mm (p = 0.0001), respectively. Univariate logistic regression showed that RAD, CSA and perimeter can independently predict VACs (OR 0.833, 95% CI 0.777-0.894, p < 0.0001; OR 0.647, 95% CI 0.541-0.773, p < 0.0001; OR 0.545, 95% CI 0.446-0.665, p < 0.0001, respectively). Ultrasonographic study of the radial artery before CCA can provide valuable information regarding vascular access.