Incidence of Complications of Trans Radial Access for Coronary Intervention

Research Article | DOI: https://doi.org/10.31579/2692-9562/055

Incidence of Complications of Trans Radial Access for Coronary Intervention

  • Iqra Hamid Khan *

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*Corresponding Author: Iqra Hamid Khan, Medical Transcription and Billing Company

Citation: Iqra Hamid Khan, Mohit Srivastava, Pratik Kumar (2022). Incidence of Complications of Trans Radial Access for Coronary Intervention Journal of Clinical Otorhinolaryngology 5(1); DOI: 10.31579/2692-9562/055

Copyright: © 2023 Iqra Hamid Khan. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Received: 07 December 2022 | Accepted: 29 December 2022 | Published: 02 January 2023

Keywords: trans radial; complications; coronary intervention

Abstract

Background: Common site of coronary intervention is Femoral artery due to its larger diameter and ease of puncture but it had certain complications but due to certain complications Radial approach has paved its way with the progression of better and successful coronary interventions with less complications.

Objective: To check safety and observe complications from the radial approach in patients undergoing coronary intervention.

Methodology:Data of 100 patients who underwent PCI by trans-radial approach was collected. Study included the procedural success, vascular complications, major cardiac events and other associated complications during hospitalization.

After the informed consent was taken from the patient, few observations were made prior to the coronary intervention and a few complications were to be noticed peri-procedural and rest complications were observed after follow up of patient.

Results: A total of 100 consecutive patients were included in the study. Mean age of patients was Mean age of the patients was 53.7 ± 11.8 years old. Gender distribution include 79% Male and 21% Female. 53.65+11.84 years. Hematoma (21%), Nausea/Vomit (31%), Pain at site of PCI (52%), Hand Ischemia (2%), major bleeding (1%) while 14% Minor bleeding and 7% Myocardial Infarction and no reported Deaths were detected from trans radial access during Percutaneous Coronary Intervention.

Conclusion:Tran’s radial route is relatively safe and tend to have less complications than Trans femoral for PCI. The occurrence of less complications and early mobilization of patient makes trans radial ideal approach for PCI.

Objective

The aim of this study was to check safety and observe complications from the radial approach in patients undergoing coronary intervention.

Introduction

Common site of coronary intervention is Femoral artery due to its larger diameter and ease of puncture but it had certain complications like bleeding, hematoma and delayed mobility [1-6].

With the progression of better and successful coronary interventions radial approach has paved the way with less complications especially when patients are taking prescribed anticoagulants, clopidogrel, aspirin and glycoprotein IIb/IIIa receptor inhibitors [7-10]. 

Campeau informed a success rate of 88% patients via radial approach without complications like vascular complications. It also increases the comfort of patient and less duration of stay in hospital [10-12]. 

Radial approach can be associated with a few problems from puncture, hemostasis or guide management, such as hematoma, pseudoaneurysm or perforation of the artery [13,14]. 

There are less number of complications observed via radial approach like bleeding bleeding, hematoma, nausea/vomiting, hand ischemia and revascularization. The use of non-surgical intervention is quite frequent.

Bleeding from the puncture site represents a leading concern after coronary stenting, sometimes it may be life-threatening and usually it prolongs the hospital stay. To prevent bleeding complications from the puncture site, the radial artery has been increasingly chosen as the route of choice for transradial approach [15,16]. 

Material & Methodology:

Study Design:

It was a cross sectional descriptive study.

Settings: 

The survey was conducted in Gulab Devi Chest Hospital, Lahore

Sampling Technique:Simple Random sampling was used. The data was collected from patients who underwent trans-radial access for coronary intervention after Myocardial Infarction.

Methodology:

Data of 100 patients who underwent PCI by trans-radial approach was collected. Study included the procedural success, vascular complications, major cardiac events and other associated complications during hospitalization.

After the informed consent was taken from the patient, few observations were made prior to the coronary intervention and a few complications  were to be noticed peri procedural and rest complications were observed after follow up of patient.

Results

Mean age of the patients was 53.65 ± 11.844 years. Gender distribution include 79% Male and 21 Female. Procedural success was achieved in 100 (Percentage) cases. Multivessel Percutaneous Coronary Intervention was done in 100(Percentage) patients. Maximum Targeted lesions treated were associated with LAD (69.61(Percentage)), RCA (42.22(Percentage)), followed by LCX (33.72(Percentage)) and LMS (3.17(Percentage)). Associated Risk factors of the patients included hypertension 39(Percentage), Diabetic were 33(Percentage), Renal insufficiency 4%, Smoking 34(Percentage), Family history for Myocardial Infarction 47& and Obesity in 11(Percentage). There was no significant association observed between the risk factors and access to trans radial site as P>0.005.

No case of vascular complications such as dissection, vascular perforation, radial artery occlusion were observed. Whereas, Hematoma or Bruising was observed in 21 patients, 31 Patients had nausea/vomiting. 52 patients had radial site pain after 24 hours of procedure, 2 patient presented with Hand Ischemia, 14 cases of minor bleeding were observed whereas, only 1 case of major bleeding. There were periprocedural myocardial infarctions observed in 7 patients and No deaths reported.

References

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