Anatomical variations affect radial artery spasm and procedural achievement of transradial cardiac catheterization

Yohei Numasawa, Akio Kawamura, Shun Kohsaka, Masashi Takahashi, Ayaka Endo, Takahide Arai, Yohei Ohno, Shinsuke Yuasa, Yuichiro Maekawa, Keiichi Fukuda

Research output: Contribution to journalArticlepeer-review

15 Citations (Scopus)

Abstract

Transradial cardiac catheterization (TRCC) has unique technical challenges such as access difficulty related to anatomical variations and/or radial artery (RA) spasm. We sought to evaluate the incidence of anatomical variations of the RA and whether they would affect RA spasm and procedural achievement of TRCC. A total of 744 consecutive patients who underwent TRCC were analyzed by routine radial arteriography. Anatomical variations were defined as abnormal origin of the RA and/or radioulnar loop and/or tortuous configuration. RA spasm was defined as >75% stenosis at first radial arteriography. Overall, anatomical variations were noted in 68 patients (9.1%), including 39 cases of abnormal origin (5.2%), 11 cases of radioulnar loop (1.5%), and 42 cases of tortuous configuration (5.6%). Transradial procedures failed in 26 patients (3.5%), and more frequently in patients with anatomical variation than in those with normal anatomy (23.5% vs 1.5%, P < 0.001). Importantly, on multivariate analysis the presence of anatomical variation was a distinct predictor of transradial procedure failure (odds ratio (OR) 17.80; 95% CI 7.55-43.73; P < 0.001). RA spasm was observed in 83 patients (11.2%), and more frequently in patients with anatomical variation than in those with normal anatomy (35.3% vs 8.7%, P < 0.001). Anatomical variation (OR 4.74; 95% CI 2.61-8.47; P < 0.001) and female gender (OR 2.23; 95% CI 1.01-4.73; P = 0.041) were distinct predictors of RA spasm. Anatomical variations were observed in 9.1% of the patients, and strongly correlated with RA spasm and procedural achievement of TRCC.

Original languageEnglish
Pages (from-to)49-57
Number of pages9
JournalHeart and vessels
Volume29
Issue number1
DOIs
Publication statusPublished - 2014 Jan

Keywords

  • Radial artery
  • Spasm
  • Transradial approach
  • Vascular access

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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