Radial artery neointimal hyperplasia after transradial PCI-Serial optical coherence tomography volumetric study

Aims Transradial catheterization (TRC) is a dominant access site for coronary catheterization and percutaneous coronary interventions (PCI) in many centers. Previous studies reported higher intimal thickness of the radial artery (RA) wall in patients with a previous history of TRC. In this investigation the aim was to assess the intimal changes of RA using the optical coherence tomography (OCT) intravascular imaging in a serial manner. Methods and results 100 patients with the diagnosis of non-ST-elevation myocardial infarction (nSTEMI) treated by PCI were enrolled (6 patients were excluded from this analysis because of occluded RA at follow-up [2 patients] and insufficient quality of OCT images [4 patients]). An 54mm long OCT run of the RA was performed immediately after the index PCI and repeated 9 months later. Volumetric analyses of the intimal layer and lumen changes were conducted. Median intimal volume at baseline versus 9 months was 33.9mm(3) (19.0; 69.4) versus 39.0mm(3) (21.7; 72.6) (p<0.001); and median arterial lumen volume was 356.3mm(3) (227.8; 645.3) versus 304.7mm(3) (186.1; 582.7) (p<0.001). There was no significant difference in the effect of any clinical factor on the RA volume changes. Conclusions OCT volumetric analyses at baseline and 9 months showed a significant increase in the radial artery intimal layer volume and a decrease in lumen volume after transradial PCI. No significant factors affecting this process were identified.