Zhongguo quanke yixue (Sep 2023)
Feasibility of Retrograde Recanalization of Occluded Radial Artery via Distal Transradial Artery Approach: a Single-center Prospective Study
Abstract
Background The incidence of radial artery occlusion (RAO) after coronary intervention via transradial artery approach (TRA) is high. But there is a lack of long-term follow-up studies with a large sample size on retrograde recanalization of occluded radial artery via distal transradial artery approach (dTRA) . Objective To assess the feasibility of dTRA for retrograde recanalization of occluded radial artery. Methods Forty-four patients undergoing retrograde recanalization via dTRA for treating RAO after coronary intervention via TRA were consecutively recruited from Shenzhen People's Hospital from June 2019 to December 2021. The primary observation index was postprocedural radial artery patency. And secondary observation index included possible predictors of failed retrograde recanalization, incidence of adverse events during hospitalization, and patency rates of radial artery at 3, 6 and 12 months after procedure. Results The success rate of postprocedural radial artery patency was 88.6% (39/44) , and divided into groups of successful (n=39) and failed (n=5) according to the result of the procedure. Compared with the successful group, the failed group had higher percentages of diabetics, current smokers and chronic total occlusion of the coronary artery, as well as a significantly lower prevalence of undergoing balloon angioplasty (P<0.05) . There was significant intergroup difference in the times of coronary interventions (P<0.05) ; there was no significant intergroup difference in the incidence of bleeding or hematoma at the access site during hospitalization (P>0.05) . The patency rates of radial artery in successful group were 48.7% (19/39) , 43.6% (17/39) , and 35.9% (14/39) at 3, 6, and 12 months after procedure, respectively. Conclusion The dTRA may be feasible for retrograde recanalization of occluded radial artery, which showed a high procedural success rate up to 88.6%, but the long-term patency rate was less than 50.0%. Diabetes, smoking, times of coronary interventions, chronic total occlusion of coronary artery, and receiving no balloon angioplasty may be influencing factors of failed retrograde recanalization of occluded radial artery via dTRA. And dTRA for retrograde recanalization of occluded radial artery is recommended for patients with RAO who also require elective coronary intervention.
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