Complications of transradial procedures

This short article aims to discuss the potential complications of transradial procedures and to set out approaches to minimising or avoiding them. Complications may relate to the operator, the patient, the equipment used or the nature of the procedure. Complications can simply be defined as minor (non-life-threatening, reversible, unlikely to extend hospital stay) or major (life-threatening, likely to cause permanent damage or to extend hospital stay). The complications of transradial procedures are rarely major and very rarely life-threatening - a major benefit of the radial approach. The potential complications can be divided into: neurovascular complications, spasm, vasovagal reactions and reflex ST segment changes. It is helpful to consider that when complications of transradial procedures occur the outcome may be: access failure; procedural failure; successful procedure but remedial action required (e.g. defibrillation, blood transfusion); or no significant problem. Radial artery puncture has been employed for arterial blood gas analysis, cannulation in intensive care units, radiological procedures (e.g. cerebral angiography) and coronary angiography and PCI. In the following five sections the main areas of complications are discussed. The Allen test has been described elsewhere and a positive Allen test is assumed throughout.