title: Chronic radial artery occlusion after transradial catheterization. Re-canalization via an ipsilateral ulnar artery.
abstract: Transradial approach to coronary angiography is a progressive and increasingly more often used technique. Apart from its advantages, radial artery occlusion (RAO) represents the most serious drawback. Re-canalization of an iatrogenic RAO, although asymptomatic in the majority of cases, remains a discussed and challenging topic. Besides its clear indications in symptomatic patients, it still remains questionable whether to perform this procedure in order to enable future repeated cannulations using the same access site and preserving the other remaining sites. For this particular reason we performed an antegrade re-canalization of an unrecognized RAO, likely a result of a previous transradial approach intervention. After a failed radial approach, the intervention was successfully performed via an ipsilateral ulnar artery. Following an uncomplicated coronary re-catheterization, RAO was angiographically diagnosed and re-canalized via the same (ulnar) access site using standard coronary equipment. Radial and ulnar artery patency were examined and checked on the following day and one month later using duplex ultrasonography.
authors.affiliation: Department of Cardiology, Clinic of Internal Medicine of 1st Medical Faculty and Central Military Hospital Prague, Central Military Hospital, Prague, Czech Republic. jan.skvaril@uvn.cz
authors.forename: Jan
authors.initials: J
authors.lastname: Skvaril
authors.forename: Radka
authors.initials: R
authors.lastname: Kockova
authors.forename: Katerina
authors.initials: K
authors.lastname: Danickova
authors.forename: Pavel
authors.initials: P
authors.lastname: Sedlon
mesh_terms: D000368:Aged; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000209:etiology* / Q000601:surgery*; D002404:Catheterization; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects*; D006801:Humans; D007049:Iatrogenic Disease; D008297:Male; D017534:Radial Artery / Q000000981:diagnostic imaging / Q000293:injuries* / Q000601:surgery*; D017535:Ulnar Artery / Q000000981:diagnostic imaging; D014654:Vascular Patency