Assessment of Vascular Complications of Repeated Transradial Access for Cardiac Catheterization

Background: Transradial catheterization has the potential to reduce procedural costs. Additionally, less staffing is needed to care for patients following transradial catheterization. Although repeated transradial procedures have undoubtedly been performed frequently at centers favouring this technique for arterial access, the utility of this approach has never been reported. Objectives: The study was designed to evaluate vascular complications and success rate in repeated ipsilateral transradial access for cardiac catheterization in comparison to the initial transradial procedure done in Beni-Suef University Hospital Cardiology Department. Methods: The study included: Group (A) including 138 patients who underwent diagnostic cardiac catheterization using initial transradial approach of the right arm. Then a subgroup of 90 patients (Group B) who had PCI by repeated ipsilateral transradial access. The ultrasonic examinations of the radial artery were performed on the same day before discharge after the initial and the repeated transradial procedure. The study was performed by an experienced cardiologist who had no knowledge of his group assignment or catheterization procedure. Follow-up assessment for vascular complications by ultrasonic examination was done within two weeks in patients with repeated ipsilateral transradial access. Results: In this study there was no statistically significant difference between group (A) and group (B) in procedure success as procedure success rate in the initial procedure was (97.83%) compared to (93.33%) in the repeated procedure with p-value of (0.326). Crossover occurred in 3 patients in the initial procedure (2.17%) due to in ability to introduce the wire in the radial artery while in the repeated ipsilateral transradial procedure crossover occurred in 6 patients (6.67%); 4 patients due to failure of radial artery cannulation, and 2 patients due to occurrence of radial artery spasm that wasn’t resolved by verapamil 10mg and nitroglycerin 100 μ g inside the sheath. Conclusion: The repeated use of the same radial artery is demonstrated to be safe and effective.