title: Treatment of radial artery occlusions using balloon angioplasty and localized intra-arterial abciximab.
abstract: OBJECTIVE
  To study an alternative strategy for the treatment of radial artery occlusion (RAO) using balloon angioplasty and intrathrombus administration of abciximab.
  
  
  BACKGROUND
  RAO is a well-described complication of transradial procedures. The optimal method to restore the patency of the radial artery following its occlusion remains unclear. Spontaneous recanalization can occur in some patients and systemic anticoagulation can be recommended but is often unsuccessful.
  
  
  METHODS
  A retrospective review of all patients in our database from 2009 to 2013 with RAO who underwent treatment with balloon angioplasty and intra-arterial abciximab administered directly at the site of occlusion.
  
  
  RESULTS
  Four patients with symptomatic RAO following transradial catheterization were treated with balloon angioplasty and a 90-second intrathrombus infusion of abciximab. All procedures were successful and patency was documented the following day with duplex sonography and again at follow-up (mean 189 days). The patients also remained free of symptoms at follow-up. The fifth patient was treated with balloon angioplasty alone. This patient suffered symptomatic reocclusion of the radial artery.
  
  
  CONCLUSIONS
  Balloon angioplasty and intrathrombus administration of abciximab via a catheter appears to be a safe, effective, and durable technique for reestablishing the patency of an occluded radial artery following transradial catheterization. Larger studies are needed to confirm our findings and establish the role for this technique in an algorithm for treatment of RAO.
authors: Indiana University Health Cardiology, Indianapolis, Indiana.
authors: Ziad
authors: Z
authors: Jaradat
authors: Babar
authors: B
authors: Basir
authors: George
authors: G
authors: Revtyak
mesh_terms: D000077284:Abciximab; D000328:Adult; D000800:Angioplasty, Balloon; D000911:Antibodies, Monoclonal / Q000008:administration & dosage*; D001157:Arterial Occlusive Diseases / Q000628:therapy*; D002404:Catheterization; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000008:administration & dosage*; D007269:Injections, Intra-Arterial; D008875:Middle Aged; D010975:Platelet Aggregation Inhibitors / Q000008:administration & dosage*; D017534:Radial Artery; D012189:Retrospective Studies
chemical_list: D000911:Antibodies, Monoclonal; D007140:Immunoglobulin Fab Fragments; D010975:Platelet Aggregation Inhibitors; D000077284:Abciximab