| Title: |
Safety and Feasibility of Retrograde Recanalization of Radial Artery Occlusion in Patients with Need for Repeated Wrist Procedures |
| Authors: |
Spiroski, Igor M.; Zafirovska, Biljana; Kedev, Sasko; Zimbakov, Zhan; Pejkov, Hristo; Kitanoski, Darko; Vasilev, Ivan; Jovkovski, Aleksandar; Taravari, Hajber; Bosev, Marijan |
| Source: |
South East European Journal of Cardiology; Vol. 3 No. 1 (2022): SEE J Cardiol; 4-10 ; 1857-9361 |
| Publisher Information: |
Scientific Foundation SPIROSKI, Skopje, Republic of Macedonia |
| Publication Year: |
2022 |
| Subject Terms: |
TRA (transradial access); RAO (radial artery occlusion); CTO (chronic total occlusion); recanalization |
| Description: |
AIM: The purpose of the study was to present a new technique of retrograde recanalization of radial artery (RA) occlusion (RAO) in patients with need for repeated wrist access percutaneous angiographic procedures. MATERIALS AND METHODS: During a 10-year period from March 2011–May 2021, 53 000 patients were referred for percutaneous coronary intervention (PCI) in a high-volume transradial center. RAO on angiography was documented in 1165 patients. Retrograde recanalization of RAO was attempted in 70 patients. The selected patients were with multiple previous bilateral wrist interventions (n = 3–9). Ipsilateral ulnar artery was usually rudimented or occluded and contralateral wrist approach could not be used. We examined clinical and procedure characteristics, access site bleeding and ischemic complications and procedural success of retrograde recanalization of RAO. Visual analog scale (VAS) score forearm pain assessment was performed after procedure. Technique: All patients had palpable pulse distal of previous puncture site due to collaterals from ipsilateral ulnar and interosseous artery. The RA was punctured with an inner metallic needle with a plastic cannula. Using retrograde radial angiography performed by injecting contrast through the plastic cannula, the occluded segment was visualized and crossed with different types of hydrophilic chronic total occlusion guide wires. After sheath insertion, balloon dilatation of the occluded RA segment, successful catheterization, and/or percutaneous coronary intervention was performed. Final RA angiography was performed on all patients. RESULTS: Successful retrograde opening of RAO was achieved in 65 out of 70 patients (92%). PCI was performed in 56% of patients through the opened RAO and 5 patients underwent CAS. Procedural success through opened RA was achieved in all 65 patients. Forearm pain during procedure was present in all cases (VAS score 3 ± 2.1). Access site bleeding EASY score 3 and 4 occurred in 6 patients (8.5%). One patient had discharge of embolic ... |
| Document Type: |
article in journal/newspaper |
| File Description: |
application/pdf |
| Language: |
English |
| Relation: |
https://seejca.eu/index.php/seejca/article/view/6037/5522; https://seejca.eu/index.php/seejca/article/view/6037 |
| DOI: |
10.3889/seejca.2022.6037 |
| Availability: |
https://seejca.eu/index.php/seejca/article/view/6037; https://doi.org/10.3889/seejca.2022.6037 |
| Rights: |
Copyright (c) 2022 Igor M. Spiroski, Biljana Zafirovska, Sasko Kedev, Zhan Zimbakov, Hristo Pejkov, Darko Kitanoski, Ivan Vasilev, Aleksandar Jovkovski, Hajber Taravari, Marijan Bosev ; http://creativecommons.org/licenses/by-nc/4.0 |
| Accession Number: |
edsbas.ED0E806B |
| Database: |
BASE |