A Transradial Approach of Cardiac Catheterization for Patients on Dialysis

Toshiki Kuno, Keita Hirano, Syohei Imaeda, Kenji Hashimoto, Toshinobu Ryuzaki, Tetsuya Saito, Hiroyuki Yamazaki, Ryota Tabei, Masaki Kodaira, Yohei Numasawa

Research output: Contribution to journalArticlepeer-review

5 Citations (Scopus)

Abstract

Background: Periprocedural bleeding is associated with increased risk of early mortality during percutaneous coronary intervention (PCI), especially in patients on dialysis. A transradial approach (TRA) should be considered for these patients; however, PCI operators avoid this approach because of the risk of radial artery occlusion (RAO). The aim of this study is to construct a TRA system and clarify its safety in patients on dialysis. Methods: Eighty-eight consecutive patients on dialysis who underwent cardiac catheterization were prospectively included in this study and divided according to the access site into either the TRA group or the transfemoral approach (TFA) group. Radial access was limited in the opposite side of arteriovenous fistula. The study endpoints were in-hospital and 30-day mortality rates, puncture-site related bleeding complications, and other complications. The study safety endpoints were procedure success rate and RAO rate in the TRA group. Results. Mean patient age was 70.4 ± 8.5 years. PCI was performed in 43 patients (48.9%). The TRA and TFA groups included 62 patients (70.5%) and 26 patients (29.5%), respectively. In-hospital and 30-day mortality rates were 0.0% in both groups. Puncture-site bleeding rates were 3.8% in the TFA group and 0.0% in the TRA group (P≤.12). Procedural success rate in the TRA group was 98.4%. Crossover to TFA was necessary in 1 patient due to radial artery spasm. RAO occurred in 4 patients (6.5%). Conclusions: Constructed TRA can be safely used in patients on dialysis. Our study could lead to an increase in TRA in these patients, which would lead to better prognosis and patient comfort.

Original languageEnglish
Pages (from-to)212-217
Number of pages6
JournalJournal of Invasive Cardiology
Volume30
Issue number6
Publication statusPublished - 2018 Jun
Externally publishedYes

Keywords

  • arteriovenous fistula
  • coronary artery disease
  • hemodialysis
  • puncture-site bleeding
  • radial approach
  • radial artery occlusion

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Cardiology and Cardiovascular Medicine

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