Upper Extremity Dysfunction after Trans-Radial Interventions- Experience from a Tertiary Care Center of North India

Abstract

Introduction: Coronary artery disease treatment by percutaneous intervention has revolutionised the management of this disease and the choice and safety of vascular access site has significantly contributed to the outcome of the overall procedure. Aim: To assess upper extremity dysfunction in patients undergoing Transradial Coronary Angiography (CAG) and Percutaneous Coronary Interventions (PCI). Materials and Methods: This study involved patients planned for transradial coronary intervention. Patients were assessed for development of upper extremity dysfunction and other local complications post procedure at 24 hours, 2 weeks, 1 month and 6 months. Data analysis was done using SPSS Version 21. Results: A total of 165 patients were enrolled in the study. There were 123 (74.5%) males. Total 156 patients (94.5%) had stable angina as underlying diagnosis, 4 (2.4%) had unstable angina, 2 (1.2%) had Non ST Elevation Myocardial Infarction (NSTEMI), 1 (0.6%) had ST Elevation Myocardial Infarction (STEMI) and 2 (1.2%) required CAG before valve replacement. A 5F sheath was used in 110 (66.67%) and 6F sheath in 55 (33.33%) cases. Tiger catheter was used in all 165 patients initially for diagnostic angiography. Dynamometer testing showed reversible downgrading of hand grip in 49% of patients post-procedure. Local site haematoma was seen in 3 (1.8%) at 24 hours, reversible vascular occlusion in 2 (1.2%) at 24 hours and Thrombolysis in Myocardial Infarction (TIMI) Minor bleed in 1 (0.6%) at 24 hours. No significant correlation was seen between sheath or catheter size with dynamometer testing or local complication. Conclusion: There was no significant upper extremity dysfunction after trans-radial intervention in the study population.