Retrograde recanalization of radial artery occlusion via the distal transradial artery: A single-center experience

Yaowang Lin; Weijie Bei; Huadong Liu; Qiyun Liu; Jie Yuan; Meishan Wu; Xin Sun; Shaohong Dong

doi:10.3389/fcvm.2022.985092

Retrograde recanalization of radial artery occlusion via the distal transradial artery: A single-center experience

Front Cardiovasc Med. 2022 Sep 23:9:985092. doi: 10.3389/fcvm.2022.985092. eCollection 2022.

Authors

Yaowang Lin¹, Weijie Bei¹, Huadong Liu¹, Qiyun Liu¹, Jie Yuan¹, Meishan Wu¹, Xin Sun¹, Shaohong Dong¹

Affiliation

¹ Department of Cardiology, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University, The First Affiliated Hospital, Southern University of Science and Technology), Cardiovascular Minimally Invasive Medical Engineering Technology Research and Development Center, Shenzhen Key Medical Discipline, Shenzhen, China.

Abstract

Background: Radial artery occlusion (RAO) often occurs after catheterization when using a transradial artery approach.

Objective: This prospective study assessed the success and feasibility of accessing the distal transradial artery (dTRA) for retrograde recanalization of RAO.

Methods: From June 2019 to December 2021, 44 consecutive patients who had undergone cardiac catheterization resulting in RAO were given retrograde recanalization via the dTRA. According to the result of the procedure (primary endpoint), patients' cases were analyzed as successful or failed. Rates of post-operative patency and adverse events were calculated up to 12 months.

Results: The procedural success rate was 88.6%. Compared with the successful group, a significantly higher percentage of patients in the failed group were current smokers and/or suffered from diabetes mellitus (each, 80.0% cf. 33.3%, P = 0.046); had undergone at least 3 previous cardiac catheterizations (60.0% cf. 12.8%, P = 0.011), lower rate of anticoagulation (30.77% cf. 0%, P = 0.048) and exhibited chronic total occlusion (100.0% cf. 51.28%, P = 0.041). In each group, one patient each had minor bleeding at the access site and hematoma. The patency rates in the successful group at postoperative 3, 6, and 12 months were 48.7, 43.6, and 35.9%, respectively.

Conclusion: The dTRA approach for retrograde recanalization of RAO showed a high procedural success rate, but with patency rates of <50% at follow-up.

Keywords: coronary angiography; distal transradial artery; geriatric disease; percutaneous coronary intervention; radial artery occlusion; retrograde recanalization.