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European Journal of Medical Research
Published in: European Journal of Medical Research 1/2018

Open Access 01-12-2018 | Research

Impact of anticoagulation and vasoactive medication on regained radial artery patency after catheterization: a case–control study

Authors: C. Rammos, A. Burghardt, J. Lortz, O. Azizy, R. A. Jánosi, M. Steinmetz, T. Rassaf

Published in: European Journal of Medical Research | Issue 1/2018

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Abstract

Background

Radial artery access is the primary approach for coronary interventions due to higher safety profile in comparison to femoral access. Radial artery occlusion (RAO) is the main complication of transradial catheterization that can lead to severe symptoms and a permanent artery occlusion. The incidence of RAO after transradial access ranges from 5 to 38% and data regarding treatment is scarce. Whether anticoagulation and vasoactive medication provides an additional benefit in recovery of radial artery patency (RAP) after catheterization has not been investigated in detail.

Aim

The objective was to investigate the impact of anticoagulation and vasoactive medication on regained patency after documented RAO following transradial catheterization.

Patients and methods

Overall 2635 patients were screened. 2215 (84%) catheterizations were performed by femoral and 420 (16%) by radial access. In 30 patients RAO was observed. In case of RAO patients were classified in three groups: Anticoagulation, anticoagulation added with alprostadil and controls. Follow-up was conducted after 3 months with ultrasound and clinical examination.

Results

Eight patients received anticoagulation and 11 patients anticoagulation together with alprostadil. Eleven patients served as controls. Recovery of RAP after catheterization was higher following either treatment (79.5%) compared to controls (0%, p = 0.006). Subgroup analysis yielded a higher RAP recovery in patients treated with anticoagulation (62.5%) as compared to controls (0%, p = 0.002). No effect on regained RAP was found with additional alprostadil therapy (33.3%) compared to anticoagulation therapy (62.5%, p = 0.229).

Conclusion

RAO should be treated with anticoagulation to regain patency. Addition of vasoactive medication does not lead to further beneficial effects. Further research is needed regarding preventive and therapeutic strategies following RAO.
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Metadata
Title
Impact of anticoagulation and vasoactive medication on regained radial artery patency after catheterization: a case–control study
Authors
C. Rammos
A. Burghardt
J. Lortz
O. Azizy
R. A. Jánosi
M. Steinmetz
T. Rassaf
Publication date
01-12-2018
Publisher
BioMed Central
Published in
European Journal of Medical Research / Issue 1/2018
Electronic ISSN: 2047-783X
DOI
https://doi.org/10.1186/s40001-018-0324-y

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