ORIGINAL ARTICLE   

Minerva Cardiology and Angiology 2023 August;71(4):414-20

DOI: 10.23736/S2724-5683.22.06112-9

Copyright © 2022 EDIZIONI MINERVA MEDICA

language: English

Radial artery occlusion after transradial procedures: impact on 1-year adverse events

Andrea PACCHIONI ¹ ✉, Gabriele PESARINI ², Jorge SANZ-SANCHEZ ^{3, 4, 5}, Gregory A. SGUEGLIA ⁶, Michele BELLAMOLI ², Jayme FERRO ⁷, Antonio MUGNOLO ¹, Riccardo MORANDIN ², Carlo PENZO ¹, Riccardo TURRI ¹, Vincenzo GUIDUCCI ⁷, Giovanni BENFARI ², Davide GIOVANNINI ², Salvatore SACCÀ ¹, Flavio L. RIBICHINI ², Francesco VERSACI ⁸, Giuseppe BIONDI-ZOCCAI ^{9, 10}, Bernhard REIMERS ³

¹ Division of Cardiology, Ospedale Civile, Mirano, Venice, Italy; ² Division of Cardiology, Department of Medicine, University of Verona, Verona, Italy; ³ Division of Cardiology, IRCCS Humanitas Clinic, Rozzano, Milan, Italy; ⁴ Division of Cardiology, La Fe University and Polytechnic Hospital, Valencia, Spain; ⁵ Centro de Investigation Biomedica en Red (CIBERCV), Madrid, Spain; ⁶ Division of Cardiology, Sant’Eugenio Hospital, Rome, Italy; ⁷ Arcispedale Santa Maria, Reggio Emilia, Italy; ⁸ UOC of Hemodynamics and Cardiology, Santa Maria Goretti Hospital, Latina, Italy; ⁹ Department of Medical and Surgical Sciences and Biotechnologies, Sapienza University, Latina, Italy; ¹⁰ Mediterranea Cardiocentro, Naples, Italy

BACKGROUND: Radial artery occlusion after transradial procedures is a frequent iatrogenic thrombotic process. The impact on prognosis has not been investigated. This study sought to investigate whether radial artery occlusion is related to increased risk of major adverse cardiac and cerebrovascular events, defined as death, myocardial infarction, stroke and coronary revascularization.
METHODS: Eight hundred thirty-seven consecutive patients who underwent a transradial coronary procedure had patency of radial artery checked at 24 hours. Radial artery occlusion occurred in 41 over 837 patients (4.8%); 764 (91.2%) were available for planned follow-up at 1 year and were included in the analysis. Event-free survival rate between patients with and without radial artery occlusion was calculated using Kaplan-Meier estimates, and Cox proportional-hazards models were used to identify independent risk factors.
RESULTS: At a median 370-day follow-up (IQR: 366-375 days), adverse events occurred in 37 patients (4.8%), 2 in patients with radial artery occlusion and 35 in patients without. One-year survival rate was 94.9% vs. 95% (unadjusted HR=1.026, 95% CI: 0.24 to 4.6, P=0.9). After multivariable modeling, age and coronary artery disease extension was associated with increased risk of adverse events.
CONCLUSIONS: Age and coronary artery disease extension were independent predictors of adverse events at follow-up. RAO had no prognostic impact.

KEY WORDS: Follow-up studies; Cardiology; Thrombosis