Background: Radial artery occlusion (RAO) may occur following transradial catheterization, precluding future use of the vessel for vascular access or as a coronary bypass graft. Recanalization of RAO may occur, however long-term radial artery patency when revascularization is more likely to be required has not been investigated. Transradial catheterization is usually performed via 5-Fr or 6-Fr catheters due to the small diameter of the vessel. Insertion of 7-Fr sheaths into the radial artery enables complex coronary interventions but may increase the risk of RAO.
Methods: We studied long-term radial artery patency in 43 patients who had undergone transradial catheterization via a 7-Fr sheath. The study endpoint was the presence of antegrade blood flow within the vessel by duplex-ultrasound.
Results: All patients had received intra-venous unfractionated heparin with a mean activated clotting time (ACT) of 247±56 seconds. Twenty-four (56%) patients had received a glycoprotein IIbIIIa inhibitor and no vascular site complications had occurred. Mean time interval from catheterization to duplex-ultrasound was 507±317 days. Asymptomatic RAO was documented in 8 (19 %) subjects. Reduced body weight was the only significant univariate predictor of RAO (78±11 vs. 89±13 kg, p=0.031). In a bivariate model using receiver operator characteristic (ROC) curves the combination of lower weight and shorter ACT offered best prediction of RAO (area under the ROC curve 0.813).
Conclusions: Asymptomatic RAO was found at late follow-up in approximately 1 in 5 patients undergoing transradial catheterization via a 7-Fr sheath and was associated with lower body weight and shorter ACT.
