Yakup Balaban1, Murat G Elevli2. 1. VM Medical Park Kocaeli Hospital, Department of Cardiology, Başiskele, Kocaeli, Turkey. 2. Sakarya Özel Adatıp Hastanesi, Kalp-Damar Cerrahisi Kliniği, Serdivan, Sakarya, Turkey.
Abstract
INTRODUCTION: Radial artery occlusions (RAOs) impose an important problem that limit transradial interventions. In this study, we represent that it is possible to perform interventions through occluded radial arteries. METHOD: Twenty-five patients with RAO who had retrograde flow shown by doppler ultrasonography were enrolled into our study. After preparing the radial region, the radial artery was accessed with a puncture needle. A 0.014″ guidewire was introduced into the brachial artery via the radial artery with the aid of balloon back up. Lesion was predilated with a drug coated peripheral balloon, and a sheath was placed at the end. RESULTS: Radial artery recanalization could be established in 22 of 25 cases and coronary angiography could be performed from those occluded radial arteries. Neither the occlusion duration nor the caliber of the radial artery had any effect on the success rate of recanalization attempts. Two patients had a hematoma because of the intervention and there were no other complications.The patency rates at 1 month follow up have been only 33.4%, too much lower than we expected. DISCUSSION AND CONCLUSION: In patients with RAO because of a previous angiographic intervention via their radial arteries may be reintervened from their occluded radial artery safely and effectively. So, our procedure is not intended for neither the recanalization nor keeping the patency of the radial artery, but suitable for those patients in whom other routes of intervention are not wanted.
INTRODUCTION: Radial artery occlusions (RAOs) impose an important problem that limit transradial interventions. In this study, we represent that it is possible to perform interventions through occluded radial arteries. METHOD: Twenty-five patients with RAO who had retrograde flow shown by doppler ultrasonography were enrolled into our study. After preparing the radial region, the radial artery was accessed with a puncture needle. A 0.014″ guidewire was introduced into the brachial artery via the radial artery with the aid of balloon back up. Lesion was predilated with a drug coated peripheral balloon, and a sheath was placed at the end. RESULTS: Radial artery recanalization could be established in 22 of 25 cases and coronary angiography could be performed from those occluded radial arteries. Neither the occlusion duration nor the caliber of the radial artery had any effect on the success rate of recanalization attempts. Two patients had a hematoma because of the intervention and there were no other complications.The patency rates at 1 month follow up have been only 33.4%, too much lower than we expected. DISCUSSION AND CONCLUSION: In patients with RAO because of a previous angiographic intervention via their radial arteries may be reintervened from their occluded radial artery safely and effectively. So, our procedure is not intended for neither the recanalization nor keeping the patency of the radial artery, but suitable for those patients in whom other routes of intervention are not wanted.