The Rotterdam Radial Access Research Ultrasound-Based Radial Artery Evaluation for Diagnostic and Therapeutic Coronary Procedures

F. Costa, M. A. H. van Leeuwen, J. Daemen, Roberto Diletti, F. Kauer, R. J. Van Geuns, J. Ligthart, K. Witberg, F. Zijlstra, Marco Valgimigli, N.M. van Mieghem

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background- Radial artery wall might be damaged after cannulation for cardiac catheterization. We investigated structural changes of the radial artery wall after catheterization to understand whether these might predict radial pulsation loss or occlusion and local pain or functional impairment of the upper extremity. Methods and Results- Ninety patients underwent transradial coronary angiography or intervention and were scanned with a high-resolution 40-MHz ultrasound before cannulation and at 3 hours and 30 days after procedure. Acute injuries of the radial artery occurred in all patients: dissection and intramural hematoma were the most common. However, these phenomena did not predict loss of radial pulsation or occlusion, local pain, or functional impairment at 30 days. Overall, the radial artery lumen was significantly reduced distal to the puncture site. Radial artery intima and total wall thickness increased 3 hours after puncture and persisted at 30 days. Radial occlusion and pulsation loss were observed in 3.9% and 9.2% of patients, respectively, at 30 days. Smaller radial artery lumen at baseline increased the risk of radial pulsation loss at 30 days (odds ratio, 1.23; P=0.049). The number of radial puncture attempts predicted pulsation loss (odds ratio, 2.64; P=0.027), occlusion (odds ratio, 3.49; P=0.022), and symptoms (odds ratio, 2.24; P=0.05) at 30-day follow-up. Conclusions- After catheterization, radial artery puncture site is associated with increased intima and total wall thickness and with modest decrease of inner lumen diameter. Acute injuries of the vessel wall were ubiquitous, but contrary to repeated puncture attempts, did not seem to affect postprocedural radial occlusion or loss of pulsation.
Original languageEnglish
Pages (from-to)10
Number of pages1
JournalCirculation-cardiovascular interventions
Volume9
DOIs
Publication statusPublished - 2016

Cite this

Costa, F. ; van Leeuwen, M. A. H. ; Daemen, J. ; Diletti, Roberto ; Kauer, F. ; Van Geuns, R. J. ; Ligthart, J. ; Witberg, K. ; Zijlstra, F. ; Valgimigli, Marco ; van Mieghem, N.M. / The Rotterdam Radial Access Research Ultrasound-Based Radial Artery Evaluation for Diagnostic and Therapeutic Coronary Procedures. In: Circulation-cardiovascular interventions. 2016 ; Vol. 9. pp. 10.
@article{ca790479b355450895239d853048d2c8,
title = "The Rotterdam Radial Access Research Ultrasound-Based Radial Artery Evaluation for Diagnostic and Therapeutic Coronary Procedures",
abstract = "Background- Radial artery wall might be damaged after cannulation for cardiac catheterization. We investigated structural changes of the radial artery wall after catheterization to understand whether these might predict radial pulsation loss or occlusion and local pain or functional impairment of the upper extremity. Methods and Results- Ninety patients underwent transradial coronary angiography or intervention and were scanned with a high-resolution 40-MHz ultrasound before cannulation and at 3 hours and 30 days after procedure. Acute injuries of the radial artery occurred in all patients: dissection and intramural hematoma were the most common. However, these phenomena did not predict loss of radial pulsation or occlusion, local pain, or functional impairment at 30 days. Overall, the radial artery lumen was significantly reduced distal to the puncture site. Radial artery intima and total wall thickness increased 3 hours after puncture and persisted at 30 days. Radial occlusion and pulsation loss were observed in 3.9{\%} and 9.2{\%} of patients, respectively, at 30 days. Smaller radial artery lumen at baseline increased the risk of radial pulsation loss at 30 days (odds ratio, 1.23; P=0.049). The number of radial puncture attempts predicted pulsation loss (odds ratio, 2.64; P=0.027), occlusion (odds ratio, 3.49; P=0.022), and symptoms (odds ratio, 2.24; P=0.05) at 30-day follow-up. Conclusions- After catheterization, radial artery puncture site is associated with increased intima and total wall thickness and with modest decrease of inner lumen diameter. Acute injuries of the vessel wall were ubiquitous, but contrary to repeated puncture attempts, did not seem to affect postprocedural radial occlusion or loss of pulsation.",
author = "F. Costa and {van Leeuwen}, {M. A. H.} and J. Daemen and Roberto Diletti and F. Kauer and {Van Geuns}, {R. J.} and J. Ligthart and K. Witberg and F. Zijlstra and Marco Valgimigli and {van Mieghem}, N.M.",
note = "M1 - 2 ISI Document Delivery No.: DE1LC Times Cited: 4 Cited Reference Count: 24 Costa, Francesco van Leeuwen, Maarten A. H. Daemen, Joost Diletti, Roberto Kauer, Floris van Geuns, Robert-Jan Ligthart, Jurgen Witberg, Karen Zijlstra, Felix Valgimigli, Marco Van Mieghem, Nicolas M. Costa, Francesco/0000-0002-3097-2834 4 1 LIPPINCOTT WILLIAMS & WILKINS PHILADELPHIA CIRC-CARDIOVASC INTE",
year = "2016",
doi = "10.1161/circinterventions.115.003129",
language = "English",
volume = "9",
pages = "10",
journal = "Circulation-cardiovascular interventions",
issn = "1941-7640",
publisher = "Lippincott Williams and Wilkins",

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The Rotterdam Radial Access Research Ultrasound-Based Radial Artery Evaluation for Diagnostic and Therapeutic Coronary Procedures. / Costa, F.; van Leeuwen, M. A. H.; Daemen, J.; Diletti, Roberto; Kauer, F.; Van Geuns, R. J.; Ligthart, J.; Witberg, K.; Zijlstra, F.; Valgimigli, Marco; van Mieghem, N.M.

In: Circulation-cardiovascular interventions, Vol. 9, 2016, p. 10.

Research output: Contribution to journalArticleAcademicpeer-review

TY - JOUR

T1 - The Rotterdam Radial Access Research Ultrasound-Based Radial Artery Evaluation for Diagnostic and Therapeutic Coronary Procedures

AU - Costa, F.

AU - van Leeuwen, M. A. H.

AU - Daemen, J.

AU - Diletti, Roberto

AU - Kauer, F.

AU - Van Geuns, R. J.

AU - Ligthart, J.

AU - Witberg, K.

AU - Zijlstra, F.

AU - Valgimigli, Marco

AU - van Mieghem, N.M.

N1 - M1 - 2 ISI Document Delivery No.: DE1LC Times Cited: 4 Cited Reference Count: 24 Costa, Francesco van Leeuwen, Maarten A. H. Daemen, Joost Diletti, Roberto Kauer, Floris van Geuns, Robert-Jan Ligthart, Jurgen Witberg, Karen Zijlstra, Felix Valgimigli, Marco Van Mieghem, Nicolas M. Costa, Francesco/0000-0002-3097-2834 4 1 LIPPINCOTT WILLIAMS & WILKINS PHILADELPHIA CIRC-CARDIOVASC INTE

PY - 2016

Y1 - 2016

N2 - Background- Radial artery wall might be damaged after cannulation for cardiac catheterization. We investigated structural changes of the radial artery wall after catheterization to understand whether these might predict radial pulsation loss or occlusion and local pain or functional impairment of the upper extremity. Methods and Results- Ninety patients underwent transradial coronary angiography or intervention and were scanned with a high-resolution 40-MHz ultrasound before cannulation and at 3 hours and 30 days after procedure. Acute injuries of the radial artery occurred in all patients: dissection and intramural hematoma were the most common. However, these phenomena did not predict loss of radial pulsation or occlusion, local pain, or functional impairment at 30 days. Overall, the radial artery lumen was significantly reduced distal to the puncture site. Radial artery intima and total wall thickness increased 3 hours after puncture and persisted at 30 days. Radial occlusion and pulsation loss were observed in 3.9% and 9.2% of patients, respectively, at 30 days. Smaller radial artery lumen at baseline increased the risk of radial pulsation loss at 30 days (odds ratio, 1.23; P=0.049). The number of radial puncture attempts predicted pulsation loss (odds ratio, 2.64; P=0.027), occlusion (odds ratio, 3.49; P=0.022), and symptoms (odds ratio, 2.24; P=0.05) at 30-day follow-up. Conclusions- After catheterization, radial artery puncture site is associated with increased intima and total wall thickness and with modest decrease of inner lumen diameter. Acute injuries of the vessel wall were ubiquitous, but contrary to repeated puncture attempts, did not seem to affect postprocedural radial occlusion or loss of pulsation.

AB - Background- Radial artery wall might be damaged after cannulation for cardiac catheterization. We investigated structural changes of the radial artery wall after catheterization to understand whether these might predict radial pulsation loss or occlusion and local pain or functional impairment of the upper extremity. Methods and Results- Ninety patients underwent transradial coronary angiography or intervention and were scanned with a high-resolution 40-MHz ultrasound before cannulation and at 3 hours and 30 days after procedure. Acute injuries of the radial artery occurred in all patients: dissection and intramural hematoma were the most common. However, these phenomena did not predict loss of radial pulsation or occlusion, local pain, or functional impairment at 30 days. Overall, the radial artery lumen was significantly reduced distal to the puncture site. Radial artery intima and total wall thickness increased 3 hours after puncture and persisted at 30 days. Radial occlusion and pulsation loss were observed in 3.9% and 9.2% of patients, respectively, at 30 days. Smaller radial artery lumen at baseline increased the risk of radial pulsation loss at 30 days (odds ratio, 1.23; P=0.049). The number of radial puncture attempts predicted pulsation loss (odds ratio, 2.64; P=0.027), occlusion (odds ratio, 3.49; P=0.022), and symptoms (odds ratio, 2.24; P=0.05) at 30-day follow-up. Conclusions- After catheterization, radial artery puncture site is associated with increased intima and total wall thickness and with modest decrease of inner lumen diameter. Acute injuries of the vessel wall were ubiquitous, but contrary to repeated puncture attempts, did not seem to affect postprocedural radial occlusion or loss of pulsation.

U2 - 10.1161/circinterventions.115.003129

DO - 10.1161/circinterventions.115.003129

M3 - Article

VL - 9

SP - 10

JO - Circulation-cardiovascular interventions

JF - Circulation-cardiovascular interventions

SN - 1941-7640

ER -