Radial artery neointimal hyperplasia after transradial PCI-Serial optical coherence tomography volumetric study

PLoS One. 2017 Oct 10;12(10):e0185404. doi: 10.1371/journal.pone.0185404. eCollection 2017.

Abstract

Aims: Transradial catheterization (TRC) is a dominant access site for coronary catheterization and percutaneous coronary interventions (PCI) in many centers. Previous studies reported higher intimal thickness of the radial artery (RA) wall in patients with a previous history of TRC. In this investigation the aim was to assess the intimal changes of RA using the optical coherence tomography (OCT) intravascular imaging in a serial manner.

Methods and results: 100 patients with the diagnosis of non-ST-elevation myocardial infarction (nSTEMI) treated by PCI were enrolled (6 patients were excluded from this analysis because of occluded RA at follow-up [2 patients] and insufficient quality of OCT images [4 patients]). An 54mm long OCT run of the RA was performed immediately after the index PCI and repeated 9 months later. Volumetric analyses of the intimal layer and lumen changes were conducted. Median intimal volume at baseline versus 9 months was 33.9mm3 (19.0; 69.4) versus 39.0mm3 (21.7; 72.6) (p<0.001); and median arterial lumen volume was 356.3mm3 (227.8; 645.3) versus 304.7mm3 (186.1; 582.7) (p<0.001). There was no significant difference in the effect of any clinical factor on the RA volume changes.

Conclusions: OCT volumetric analyses at baseline and 9 months showed a significant increase in the radial artery intimal layer volume and a decrease in lumen volume after transradial PCI. No significant factors affecting this process were identified.

MeSH terms

  • Aged
  • Aged, 80 and over
  • Cardiac Catheterization / adverse effects*
  • Coronary Angiography / adverse effects
  • Coronary Angiography / methods
  • Female
  • Humans
  • Hyperplasia / diagnostic imaging
  • Hyperplasia / etiology
  • Hyperplasia / physiopathology
  • Male
  • Middle Aged
  • Myocardial Infarction / diagnostic imaging
  • Myocardial Infarction / physiopathology
  • Myocardial Infarction / therapy*
  • Neointima / diagnostic imaging
  • Neointima / physiopathology
  • Percutaneous Coronary Intervention / adverse effects*
  • Radial Artery / diagnostic imaging
  • Radial Artery / physiopathology
  • Tomography, Optical Coherence*
  • Tunica Intima / diagnostic imaging
  • Tunica Intima / physiopathology

Grants and funding

This study was supported by the grant of the Internal Grant Agency of the Ministry of Health of the Czech Republic NT/13830-4.