Ahmad Farooq, Ullah Ikram, Khan Sher W
Cardiology, Khyber Medical College/Khyber Teaching Hospital, Peshawar, PAK.
Interventional Cardiology, Fauji Foundation Hospital, Peshawar, PAK.
Cureus. 2024 Apr 11;16(4):e58036. doi: 10.7759/cureus.58036. eCollection 2024 Apr.
Background Transradial access (TRA) is a medical procedure primarily used for percutaneous coronary interventions (PCI) and cardiac catheterization. Based on the recently published Minimizing Adverse Haemorrhagic Events by Transradial Access Site and Systemic Implementation of AngioX (MATRIX) trial, TRA is being used more frequently than transfemoral access (TFA) since it has reduced rates of bleeding and fatality. A structural complication of TRA is radial artery occlusion (RAO), which may cause temporary pain to limit TRA in the future. Objective This study aimed to investigate the onset and risk factors of RAO following TRA for coronary interventions. Material and methods An observational study was conducted at Fauji Foundation Hospital in Peshawar, Pakistan. The study included 1,680 patients recruited between April 2021 to December 2023. Fifty-eight patients were lost to follow-up, while another 95 patients did not come for a visit within the study period. The final study, therefore, included 1,527 patients. Results The mean age of patients was 58.09 ± 8.07 years. Patients were divided into two age groups (greater or less than 60 years). Diagnostic angiograms were completed for 955 patients, while 572 also underwent PCI. The overall RAO onset was 81 (5.3%). There was a significantly higher RAO onset in patients over 60 years old (7.1 vs 3.8%, p = 0.003). Conclusion Overall, the risk of RAO is low following TRA. The risk of RAO is significantly higher in people aged over 60 years.
背景 经桡动脉入路（TRA）是一种主要用于经皮冠状动脉介入治疗（PCI）和心导管检查的医疗程序。根据最近发表的《通过经桡动脉入路部位和血管造影X系统的全身实施来最小化不良出血事件》（MATRIX）试验，TRA的使用频率比经股动脉入路（TFA）更高，因为它降低了出血和死亡率。TRA的一种结构性并发症是桡动脉闭塞（RAO），这可能会导致暂时性疼痛，从而限制未来TRA的使用。目的 本研究旨在调查冠状动脉介入治疗经TRA后RAO的发生情况及危险因素。材料与方法 在巴基斯坦白沙瓦的法吉基金会医院进行了一项观察性研究。该研究纳入了2021年4月至2023年12月期间招募的1680例患者。58例患者失访，另有95例患者在研究期间未前来就诊。因此，最终研究纳入了1527例患者。结果 患者的平均年龄为58.09±8.07岁。患者被分为两个年龄组（大于或小于60岁）。955例患者完成了诊断性血管造影，572例患者还接受了PCI。RAO的总体发生率为81例（5.3%）。60岁以上患者的RAO发生率显著更高（7.1%对3.8%，p=0.003）。结论 总体而言，经TRA后RAO的风险较低。60岁以上人群RAO的风险显著更高。
