Short sheath benefit in radial artery injury after PCI -optical coherence tomography serial study
2016
Background and Aims: Transradial catheterization is the
predominant access site for coronary catheterization and
percutaneous coronary interventions (PCI). Previous studies
have reported a high incidence of radial artery (RA) injury.
The aim of this investigation was to evaluate the incidence of
RA injury using last generation optical coherence tomography
(OCT) intravascular imaging in a serial manner. Methods: 100
patients with a diagnosis of non-ST-elevation myocardial
infarction (nSTEMI) treated by PCI were enrolled. OCT of RA was
performed immediately after the index PCI. OCT was repeated 9
months later. Results: There were 11 patients with RA injuries
(11.0%) at baseline, including 3 patients with RA medial
dissection and 8 patients with intimal tears. In the follow-up
OCT data, the number of RA injuries was 10 (10.0%), including 7
patients with RA medial dissection and 3 patients with intimal
tear. All injuries were clinically asymptomatic and there was
no finding of vessel perforation. There was no significant
difference between the baseline and follow-up procedure in
terms of number of injuries. Conclusion: The study showed no
significant difference between baseline and follow-up RA injury
incidence. There was a higher risk of radial injury for
repeated catheterization in women. The conclusion is that
radial catheterization is a very safe procedure in terms of
radial artery damage. This is evidenced by considerably fewer
injuries compared to published studies. The use of the short
radial sheath (7 cm in this study) is protective and reduces
the incidence of radial injury.
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