Transradial approach (TRA) is the default access site for diagnostic angiography and
intervention in many centers. Repeat ipsilateral radial artery access late after index
procedure has been associated with failures. It is unknown whether early (≤30 days)
and very early (<24 hours) repeat radial access is technically feasible and safe.
Study population consisted of consecutive patients undergoing repeat (≥2) procedures
within 30 days in a high-volume TRA center. Transradial access failure and resulting
femoral approach was categorized as primary (no repeat attempt) or secondary (crossover).
Timing of repeat access and reasons for failure were recorded. From November 2012
to December 2014, repeat catheterization by TRA was performed twice in 573 of 626
patients (92%) (median delay 4 [2 to 9] days), 3 times in 29 of 38 (76%) patients
(median delay 15 [5 to 26] days), and 4 times in 1 patient within 21 days. When repeat
catheterization occurred during the first 24 hours following the index procedure,
53% and 75% of patients had second and third procedures using the same ipsilateral
radial artery, respectively. Primary radial failure occurred in 5.8% for second attempt
and 13% for a third attempt, whereas crossovers were noted in 2.7% and 2.6%, respectively.
Main reasons for failed re-access of ipsilateral radial artery were related either
to operator's reluctance to repeat attempt (primary failure) or to issues with puncture
site (crossover). In a high-volume TRA center, patients who required repeat catheterization
within 24 hours and within the first 30 days had the same radial artery re-accessed
in the majority of cases.
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Article Info
Publication History
Published online: August 02, 2017
Accepted:
July 7,
2017
Received:
May 13,
2017
Footnotes
See page 1271 for disclosure information.
Identification
Copyright
© 2017 Elsevier Inc. All rights reserved.
