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IMPROVING SUCCESS OF TRANSRADIAL INTERVENTIONS IN SMALL ARTERIES (IRIS): A RANDOMIZED STUDY USING “COMPRESSION OF THE ULNAR ARTERY TECHNIQUE” IN SMALL RADIAL ARTERIES TO IMPROVE PROCEDURAL OUTCOMES
67 JACC April 5, 2016 Volume 67, Issue 13
ACC.i2 Interventional Cardiology IMPROVING SUCCESS OF TRANSRADIAL INTERVENTIONS IN SMALL ARTERIES (IRIS): A RANDOMIZED STUDY USING “COMPRESSION OF THE ULNAR ARTERY TECHNIQUE” IN SMALL RADIAL ARTERIES TO IMPROVE PROCEDURAL OUTCOMES Poster Contributions Poster Area, South Hall A1 Saturday, April 02, 2016, 10:00 a.m.-10:45 a.m. Session Title: ACC.i2 Interventional Cardiology: Vascular Access and Complications Abstract Category: 12. ACC.i2 Interventional Cardiology: Vascular Access and Complications Presentation Number: 1106-167 Authors: Sanjay Chugh, Yashasvi Chugh, Sunita Chugh, Satyajit Bose, The Mission Hospital, Durgapur, India, Jacobi Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
Background: Transradial access has gained popularity because of patient comfort and reduced vascular complications. However, small radial arteries still pose a major challenge as they are associated with procedural failure and increased post-procedure radial artery occlusion(PPRAO) .We aimed to assess the impact of compression of ulnar artery, on the ipsilateral radial artery diameter, using color Doppler, as well as on outcomes of puncture and procedure success; crossover, radial artery spasm, procedure time( time from first contact of puncture needle with skin to final 0.035” guide wire removal), fluoroscopy time and PPRAO. Methods: A total of 168 patients undergoing Transradial coronary angiograms (TRCA), were prospectively enrolled in the study. 84 patients were randomized to compression of the ulnar artery or COUA group; while an equal number were randomized to non-COUA(NC) group. Patients with pre- procedure radial arteries >1.7mm internal diameter by color doppler and post- coronary bypass patients were excluded. Post- procedure radial artery patency was recorded via color Doppler. Results: Sex distribution(Male/Female), puncture and procedure success, crossovers, radial artery spasm, procedure and fluoroscopy time and post-procedure radial artery occlusion at 30 days was (59/25 vs 54/30)(p=ns); (97.8%vs88%)(p<0.001); (99% vs 97%)(p<0.001); (2.1±0.2% vs 5±3.1%)(p<0.001); (2.7% vs 13%)(p<0.001); (8.7±5min vs 14±5.6min)(p<0.001); (2±3min vs 2.8±2.6min)(p=0.06); (4.8% vs 6%)(p=ns) in the COUA vs NC groups respectively. Conclusions: COUA was associated with higher procedural success and lower crossovers, procedure time and radial artery spasm, in patients with small <1.7mm radial arteries. However, PPRAO rate and fluoroscopy time was not significantly different with and without the use of COUA.
ACC.i2 Interventional Cardiology IMPROVING SUCCESS OF TRANSRADIAL INTERVENTIONS IN SMALL ARTERIES (IRIS): A RANDOMIZED STUDY USING “COMPRESSION OF THE ULNAR ARTERY TECHNIQUE” IN SMALL RADIAL ARTERIES TO IMPROVE PROCEDURAL OUTCOMES Poster Contributions Poster Area, South Hall A1 Saturday, April 02, 2016, 10:00 a.m.-10:45 a.m. Session Title: ACC.i2 Interventional Cardiology: Vascular Access and Complications Abstract Category: 12. ACC.i2 Interventional Cardiology: Vascular Access and Complications Presentation Number: 1106-167 Authors: Sanjay Chugh, Yashasvi Chugh, Sunita Chugh, Satyajit Bose, The Mission Hospital, Durgapur, India, Jacobi Medical Center/Albert Einstein College of Medicine, Bronx, NY, USA
Background: Transradial access has gained popularity because of patient comfort and reduced vascular complications. However, small radial arteries still pose a major challenge as they are associated with procedural failure and increased post-procedure radial artery occlusion(PPRAO) .We aimed to assess the impact of compression of ulnar artery, on the ipsilateral radial artery diameter, using color Doppler, as well as on outcomes of puncture and procedure success; crossover, radial artery spasm, procedure time( time from first contact of puncture needle with skin to final 0.035” guide wire removal), fluoroscopy time and PPRAO. Methods: A total of 168 patients undergoing Transradial coronary angiograms (TRCA), were prospectively enrolled in the study. 84 patients were randomized to compression of the ulnar artery or COUA group; while an equal number were randomized to non-COUA(NC) group. Patients with pre- procedure radial arteries >1.7mm internal diameter by color doppler and post- coronary bypass patients were excluded. Post- procedure radial artery patency was recorded via color Doppler. Results: Sex distribution(Male/Female), puncture and procedure success, crossovers, radial artery spasm, procedure and fluoroscopy time and post-procedure radial artery occlusion at 30 days was (59/25 vs 54/30)(p=ns); (97.8%vs88%)(p<0.001); (99% vs 97%)(p<0.001); (2.1±0.2% vs 5±3.1%)(p<0.001); (2.7% vs 13%)(p<0.001); (8.7±5min vs 14±5.6min)(p<0.001); (2±3min vs 2.8±2.6min)(p=0.06); (4.8% vs 6%)(p=ns) in the COUA vs NC groups respectively. Conclusions: COUA was associated with higher procedural success and lower crossovers, procedure time and radial artery spasm, in patients with small <1.7mm radial arteries. However, PPRAO rate and fluoroscopy time was not significantly different with and without the use of COUA.