Recanalization of the post-catheterization occlusion of the radial artery.

Aleksandr Kaledin North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg, Russia Petr Podmetin North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg, Russia Igor Kochanov North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg, Russia Sergey Seletskiy North-Western State Medical University named after I.I. Mechnikov, Saint-Petersburg, Russia

Objective. To evaluate the possibility and advisability of antegrade and retrograde recanalization of the post-catheterization radial artery occlusion (PCRAO).

Methods. Recanalization of occlusions was performed retrogradely (accessed through the distal RA on the hand) and antegradely (accessed through the ipsilateral ulnar artery) with the hand dynamic strength assessment by the wrist exerciser prior to and after the recanalization. Patency of the recanalized artery was estimated in 1 month after the recanalization via the ultrasound or angiography.

Results. Recanalization PCRAO was performed in 89 patients. Total successful recanalization was performed in 72 (81%) patients. Success with retrograde approach noted in 42% of patients, with antegrade approach – in 58%. Patency of the recanalized PCRAO was controlled in 86% of patients. Reocclusion after the retrograde method was detected in 30% of cases and only in 17% after the antegrade method. After PCRAO recanalization 52% patients had an improvement in hand dynamic strength. In 48% of patients improvement did not occur.

Conclusions. PCRAO recanalization provides its repeated use during subsequent PCI. Antegrade approach is more preferable as compared to the retrograde one. Success rate of the antegrade recanalization is lower as compared to the retrograde one due to frequent absence of “stump” of the occluded RA. PCRAO recanalization demonstrated an insignificant increase of the hand and forearm dynamic strength. Simultaneous PCRAO recanalization and endovascular procedure increase a total time of procedure, the time and dose of the fluoroscopy as well as the contrast agents volume.