P6523Radial artery occlusion: predictors, methods for reducing the frequency of complications-a single center study

• Published in: European heart journal Vol. 40; no. Supplement_1
• Main Authors: Ognerubov, D, Tereshchenko, A, Merkulov, E, Provatorov, S, Arutyunyan, G, Ehrtman, V, Silin, N, Tripoten', M, Pogorelova, O, Balahonova, T, Samko, A
• Format: Journal Article
• Language: English
• Published: Oxford University Press 01.10.2019
• Subjects: Coronary Intervention: Vascular Access
• ISSN: 0195-668X; 1522-9645
• DOI: 10.1093/eurheartj/ehz746.1113

Abstract Radial access has great advantages in terms of the frequency of complications, but it has one specific complication - radial artery occlusion (RAO). This complication often does not manifest itself in any way; however, it limits the use of access for the future interventions. Aim To compare methods of short and traditional hemostasis and to identify the main predictors of RAO after radial access. Materials and methods During the period from 2012 to 2018, 2000 patients were included in the study, which consisted of two parts: prospective - 1000 patients who underwent coronary angiography and percutaneous coronary intervention (PCI) with stable coronary artery disease, and retrospective part of the study, which included 1000 patients admitted for PCI from other clinics. In a prospective study, patients were divided into two groups: after coronary angiography and PCI, respectively (n=500 in the coronary angiography group and n=500 in the PCI group), and then randomized. Hemostatic bandages in the first group of patients (n=250) were removed after 12–24 hours, in the second group (n=250) - after 4±1 hours. When the occlusion of the radial artery was detected, all patients underwent an hour-long compression of the ipsilateral ulnar artery to recanalize acute RAO. Results The frequency of RAO in the retrospective part of the study was 21.8%. The frequency of RAO in the prospective part of the study was 10.2% with a traditional time hemostasis and 1.4% with a short-time compression (P<0.001). Predictors of the RAO are illustrated in table 1. Predictors of bleeding were PCI (OR 0.12, 95% CI 0.01–0.67, P=0.05) and weight (OR 1.09, 95% CI 1.02–1.18, P=0.01). Table 1. Predictors of RAO Variables Odds ratio 95% Confidential interval Significance, P Traditional-time hemostasis 8.78 4.2–21.5 <0.001 Diabetes mellitus+smoking 18.1 12.7–26.7 <0.001 Diabetes mellitus 0.45 0.25–0.83 0.009 Body mass index 0.95 0.91–0.99 0.02 Male 1.75 1.01–3.18 0.05 Protein C 0,86 0,75–0,96 0,01 Conclusion Careful examination of the patient for detecting RAO before and after interventions is essential. Short hemostasis with compression of the ipsilateral ulnar artery reduce the frequency of RAO. For short-time hemostasis, special attention should be paid to patients after PCI and with low BMI, as far as these factors are associated with a greater risk of bleeding after removal of the compression bandage.