Radial artery anomalies in the Macedonian population during transradial angiography procedures

Objective: To assess the incidence of ar- terial 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 appro- ach for angiography procedures mostly due to the anato- mic 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 De- cember 2014 were examined. Preprocedural radial ar- tery angiography was performed in all patients. Clini- cal and procedure characteristics, type and incidence of vascular anatomy variants and access site complica- tions 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 arteri- es in 1017 (5.5%) patients, 227 (1.2%) had extreme ra- dial 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 ar- teries. 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 anat- omy of the radial artery helps the interventional cardio- logist in successfully planning and performing this procedure. Radial artery angiography is strongly enco- uraged in every patient before the begining of the tran-