Analysis of radial artery occlusion causes and methods of its prevention after interventions using radial access. Results of the APRIORI study

Ognerubov D.V. Provatorov S.I. Merkulov E.V. Tereshchenko A.S. Kupina K.I. Pogorelova O.A. Tripoten M.I. Balakhonova T.V. Kairaliev D.M. Grossman A.E. Osokina A.K. Potekhina A.V. Samko A.N.
2021 Silicea-Poligraf

Russian Journal of Cardiology
2021 #26 Issue 12 95 - 102 pp.

Aim. To study predictors of radial artery occlusion (RAO) and ways to prevent it after interventions using radial access. Material and methods. The study consisted of prospective and retrospective parts. The total number of included patients was 2284. Patients undergoing interventions by radial access in various medical organizations were retrospectively considered. The prospective study included 1284 patients who were subject tointerventional treatment. Patients were randomized into two groups as follows: in group 1, hemostasis was performed within 4 hours, in group 2 — >6 hours. All patients underwent a bedside Barbeau test with a pulse oximeter and an ultrasound of access arteries to determine the radial artery patency/occlusion. Results. The RAO rate in the retrospective part was 21,8%, while in the prospective one — 10,1% with long-term hemostasis and 1,4% with short-term hemostasis (p<0,001). Predictors of RAO were type 2 diabetes (odds ratio (OR), 1,9, 95% con-fidence interval (CI), 1,1-3,4, p=0,03) and an increase in hemostasis duration by 1 hour (OR, 1,2, 95% CI, 1,1-1,3, p<0,001). When analyzing the retrospective part, the predictors of RAO were body mass index (OR, 1,06, 95% CI, 1,02-1,09, p=0,002), female sex (OR, 0,6, 95% CI, 0,4-0,9, p=0,02), smoking (OR, 1,38, 95% CI, 1-1,91, p=0,047). The administration of statins in different dosages, as well as antihyper-tensive and anti-ischemic agents, did not have a significant effect on the RAO rate. Conclusion. The main predictors of RAO were type 2 diabetes, an increase in hemostasis duration, female sex, smoking, and the artery-to-introducer diameter ratio. Taking statins, anti-ischemic and antihypertensive agents does not have a protective effect on RAO rate.

Complications , Coronary angiography , Coronary artery disease , Percutaneous coronary intervention , Radial access , Radial artery occlusion

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National Medical Research Center of Cardiology, Moscow, Russian Federation
Federal Research and Clinical Center for Sports Medicine and Rehabilitation of Federal Medical Biological Agency, Moscow, Russian Federation
City Clinical Hospital № 7, Alma-Ata, Kazakhstan
Reutov Central City Clinical Hospital, Reutov, Russian Federation

National Medical Research Center of Cardiology
Federal Research and Clinical Center for Sports Medicine and Rehabilitation of Federal Medical Biological Agency
City Clinical Hospital № 7
Reutov Central City Clinical Hospital

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