title: Revealing the impact of local access-site complications and upper extremity dysfunction post transradial percutaneous coronary procedures.
abstract: OBJECTIVE
  Little is known about local access-site complications and upper extremity dysfunction after transradial percutaneous coronary procedures (TR-PCP). This systematic review study aimed to summarise the current knowledge on the incidences of access-site complications and upper extremity dysfunction after TR-PCP.
  
  
  METHODS
  Two independent, trained investigators searched MEDLINE, EMBASE and CENTRAL for eligible studies published before 1 January 2015. Also, they hand-searched the conference proceedings of the annual scientific sessions of the American College of Cardiology, the American Heart Association, European Society of Cardiology, and the Trans-catheter Cardiovascular Therapeutics. Inclusion criteria were cohort studies and clinical trials discussing the incidence of access-site complications and upper extremity function after transradial percutaneous coronary intervention (TR-PCI) and/or transradial coronary angiography (TR-CAG) as endpoints.
  
  
  RESULTS
  176 articles described access-site complications. The incidence is up to 9.6 %. Fourteen articles described upper extremity dysfunction, with an incidence of up to 1.7 %. Upper extremity dysfunction was rarely investigated, hardly ever as primary endpoint, and if investigated not thoroughly enough.
  
  
  CONCLUSIONS
  Upper extremity dysfunction in TR-PCP has never been properly investigated and is therefore underestimated. Further studies are needed to investigate the magnitude, prevention and best treatment of upper extremity dysfunction. Optimising TR-PCP might be achieved by using slender techniques, detection of upper extremity dysfunction and early referral to a hand rehabilitation centre.
authors.affiliation: Department of Cardiology, Albert Schweitzer Hospital, Dordrecht, the Netherlands.
authors.forename: E M
authors.initials: EM
authors.lastname: Zwaan
authors.affiliation: Department of Cardiology, Albert Schweitzer Hospital, Dordrecht, the Netherlands.
authors.forename: A G M M
authors.initials: AG
authors.lastname: Koopman
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, Albert Schweitzer Hospital, Dordrecht, the Netherlands.
authors.forename: C A J
authors.initials: CA
authors.lastname: Holtzer
authors.affiliation: Department of Cardiology, Erasmus University, Rotterdam, the Netherlands.
authors.forename: F
authors.initials: F
authors.lastname: Zijlstra
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, VU University, Amsterdam, the Netherlands.
authors.forename: M J P F
authors.initials: MJ
authors.lastname: Ritt
authors.affiliation: Department of Cardiology, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands.
authors.forename: G
authors.initials: G
authors.lastname: Amoroso
authors.affiliation: Department of Plastic, Reconstructive and Hand Surgery, Onze Lieve Vrouwe Gasthuis, Amsterdam, the Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: Moerman
authors.affiliation: Department of Cardiology, Albert Schweitzer Hospital, Dordrecht, the Netherlands.
authors.forename: M J M
authors.initials: MJ
authors.lastname: Kofflard
authors.affiliation: Department of Cardiology, Albert Schweitzer Hospital, Dordrecht, the Netherlands. s.ijsselmuiden@asz.nl.
authors.forename: A A J
authors.initials: AA
authors.lastname: IJsselmuiden
keywords: Access-site complication; Radial artery; Upper extremity dysfunction