title: Incidence and predictors of radial artery occlusion after transradial coronary angioplasty: Doppler-guided follow-up study.
abstract: OBJECTIVE
  To evaluate the incidence and predictors of radial artery occlusion (RAO) after transradial coronary angioplasty (TRA).
  
  
  BACKGROUND
  RAO can occur after TRA but has not been well studied by serial vascular Doppler examination.
  
  
  METHODS
  A total of 198 patients undergoing TRA were included. Radial pulse and Doppler examination of the radial artery were performed 1 day before, 1 day after, and 3 months after the procedure. RAO was defined as an absence of antegrade flow on Doppler studies. Logistic regression analysis was done to evaluate the predictors of RAO.
  
  
  RESULTS
  The mean radial arterial diameter was 2.8 ± 0.4 mm. On the day after TRA, radial artery Doppler examination revealed RAO in 30 patients (15.2%). Radial pulse was still palpable in 30.0% of these patients. All of them were asymptomatic. At 3-month follow-up, no new RAO was noted. Interestingly, the radial artery had spontaneously recanalized in 8 patients (26.7%) with RAO. Patients with persistent RAO remained asymptomatic. On univariate analysis, female sex, diabetes, lower body mass index, radial artery diameter ≤2.5 mm, lower peak systolic velocity, and radial artery to sheath ratio <1 were predictors of RAO. Interestingly, procedural characteristics and duration of the procedure were not identified as predictors of RAO. On multivariate analysis, radial artery diameter ≤2.5 mm and preprocedural peak systolic velocity emerged as independent predictors for RAO.
  
  
  CONCLUSIONS
  Asymptomatic RAO occurs in about 15% of patients after TRA. Spontaneous recanalization occurs in about one-fourth of these patients. Preprocedure radial artery inner diameter ≤2.5 mm and peak systolic velocity are the independent predictors of RAO.
authors: Department of Cardiology, Sanjay Gandhi PGIMS, Raibareli Road, Lucknow, India. navgarg@sgpgi.ac.in.
authors: Naveen
authors: N
authors: Garg
authors: B K
authors: BK
authors: Madan
authors: Roopali
authors: R
authors: Khanna
authors: Archana
authors: A
authors: Sinha
authors: Aditya
authors: A
authors: Kapoor
authors: Satendra
authors: S
authors: Tewari
authors: Sudeep
authors: S
authors: Kumar
authors: Pravin Kumar
authors: PK
authors: Goel
mesh_terms: D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects*; D001157:Arterial Occlusive Diseases / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000209:etiology*; D006328:Cardiac Catheterization / Q000009:adverse effects*; D003324:Coronary Artery Disease / Q000601:surgery*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D009204:Myocardial Revascularization / Q000009:adverse effects*; D017534:Radial Artery / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D018608:Ultrasonography, Doppler / Q000379:methods*; D014481:United States / Q000453:epidemiology