RADIAL ARTERY ANOMALIES IN THE MACEDONIAN POPULATION DURING TRANSRADIAL ANGIOGRAPHY PROCEDURES

Biljana Zafirovska, Danica Petkoska, Slobodan Antov, Ivan Vasilev, Aleksandar Jovkovski, Oliver Kalpak, Jorgo Kostov, Igor Spiroski, Hristo Pejkov, Marjan Bosev, Hajber Taravari, Darko Kitanoski, Sasko Kedev

Abstract


Objective: To assess the incidence of arterial anomalies of the radial artery in the Macedonian population registered during transradial access (TRA) angiography procedures in a large series of patients.

Background: Transradial angiography (TRA) is now the recommended access for percutaneous coronary intervention, but technically is a more challenging approach for angiography procedures mostly due to the anatomic anomalies on the radial artery, which may influence the success rate of transradial angiographic procedures.

Methods: All consecutive 19292 patients from our Center, in the period from March 2011 until December 2014 were examined. Preprocedural radial artery angiography was performed in all patients. Clinical and procedure characteristics, type and incidence of vascular anatomy variants and access site complications were analyzed.

Results:  Anatomical variants were present in 1625 (8.8%) patients. The most frequent was high-bifurcating radial artery origin from the axillary and brachial arteries in 1017(5.5%) patients, 227 (1.2%) had extreme radial artery tortuosity, 176(0.95%) had a full radial loop, 32(0.17%) with hypoplastic radial artery and 173(0.9%) had tortuous brachial, subclavian and axillary arteries. Radial artery spasm was very common in patients with present radial artery anomalies.

Conclusion:  Radial artery anomalies are very common in the general population. Knowing the anatomy of the radial artery helps the interventional cardiologist in successfully planning and performing this procedure. Radial artery angiography is strongly encouraged in every patient before the begining of the transradial angiography procedures.


Keywords


TRA(Transradial artery access), RA(Radial artery), TFA(Transfemoral artery access), Vascular anatomy variants

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References


Hamon M, Pristipino C, Di Mario C et al. Consensus document on the radial approach in percutaneous cardiovascular interventions: position paper by the European Association of Percutaneous Cardiovascular Interventions and Working Groups on Acute Cardiac Care and Thrombosis of the European Society of Cardiology. EuroIntervention. 2013;8(11):1242-51.

Rodriguez-Niedenfuhr M, Vazquez T, Nearn L, Ferreira B, Parkin I, Sanudo JR. Variations of the arterialpattern in the upper limb revisited: a morphological and statistical study, with a review of the literature. J Anat. 2001;199(Pt 5):547–66.

McCormack LJ, Cauldwell EW, Anson BJ. Brachial and antebrachial arterial patterns; a study of 750 extremities. Surg Gynecol Obstet. 1953;96(1):43–54.

Burzotta F, Brancati MF, Trani C et al. Impact of radial-to-aorta vascular anatomical variants on risk of failure in trans-radial coronary procedures. Catheter Cardiovasc Interv. 2012;80(2):298-303.

Lo TS, Nolan J, Fountzopoulos E et al. Radial artery anomaly and its influence on transradial coronary procedural outcome. Heart. 2009 ;95(5):410-5.

Valsecchi O, Vassileva A, Musumeci G et al. Failure of transradial approach during coronary interventions: anatomic considerations. Cathet Cardiovasc Interv. 2006;67(6):870-8.

Nie B, Zhou YJ, Li GZ, Shi DM, Wang JL.Clinical study of arterial anatomic variations for transradial coronary procedure in Chinese population. Chin Med J (Engl). 2009;122(18):2097-102.

Uglietta JP, Kadir S. Arteriographic study of variant arterial anatomy of the upper extremities. Cardiovasc Intervent Radiol. 1989;12(3):145–8.

Yoo BS, Yoon J, Ko JY, et al. Anatomical consideration of the radial artery for transradial coronary procedures: arterial diameter, branching anomaly and vessel tortuosity. Int J Cardiol. 2005;101(3):421–7.

Rao SV, Ou FS, Wang TY et al. Trends in the prevalence and outcomes of radial and femoral approaches to percutaneous coronary intervention: a report from the National cardiovascular data registry. JACC Cardiovasc Interv. 2008;1(4):379-86.

Pristipino C, Trani C, Nazzaro MS et al. Major improvement of percutaneous cardiovascular procedure outcomes with radial artery catheterisation: results from the PREVAIL study. Heart. 2009;95(6):476-82.

Hetherington SL, Adam Z, Morley R et al. Primary percutaneous coronary intervention for acute ST-segment elevation myocardial infarction: changing patterns of vascular access, radial versus femoral artery. Heart. 2009;95(19):1612-8.

Rao SV, Cohen MG, Kandzari DE, Bertrand OF, Gilchrist IC. The transradial approach to percutaneous coronary intervention: historical perspective, current concepts, and future directions. J Am Coll Cardiol. 2010;55(20):2187-195.

Goldsmit A, Kiemeneij F, Gilchrist IC, et al. Radial artery spasm associated with transradial cardiovascular procedures: Results from the RAS registry. Catheter Cardiovasc Interv. 2014;83(1):E32-6. doi: 10.1002/ccd.25082.

Kiemeneij F. Prevention and management of radial artery spasm. J Invasive Cardiol. 2006;18(4):159-60.

Bertrand OF, De Larochelliere R, Cabau JR et al. Early Discharge After Transradial Stenting of Coronary Arteries (EASY) study investigators. A randomized study comparing same-day home discharge and abciximab bolus only to overnight hospitalization and abciximab bolus and infusion after transradial coronary stent implantation. Circulation. 2006;114(24):2636-43.

Yoo BS, Yoon J, Ko JY, et al. Anatomical consideration of the radial artery for transradial coronary procedures: arterial diameter, branching anomaly and vessel tortuosity. Int J Cardiol. 2005;101(3):421–7.

Etxegoien N, Rhyne D, Kedev S, Sachar R, Mann T. The transradial approach for carotid artery stenting. Catheter Cardiovasc Interv. 2012 ;80(7):1081-7.

Hawkins BM, Drachman DE. Transradial access for carotid stenting: exceptional outcomes in experienced hands… will the results be generalizable? Catheter Cardiovasc Interv. 2012;80(7):1088-9.

Trani C, Tommasino A, Burzotta F.Pushing the limits forward: transradial superficial femoral artery stenting. Catheter Cardiovasc Interv. 2010;76(7):1065-71.

Luo JF, Wang HY, Huang WH, et al.Transradial artery intervention: an alternative approach for renal artery stent implantation? Chin Med J (Engl).2012;125(18):3340-3.

Trani C, Tommasino A, Burzotta F. Transradial renal stenting: why and how. Catheter Cardiovasc Interv. 2009;74(6):951-6.

Louvard Y, Lefèvre T. Loops and transradial approach in coronary diagnosis and intervention. Catheter Cardiovasc Interv. 2000;51(2):250-2.




DOI: http://dx.doi.org/10.24125/sanamed.v11i2.129

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