title: Radial Artery Occlusion After Transradial Interventions: A Systematic Review and Meta-Analysis.
abstract: BACKGROUND
  Radial artery occlusion (RAO) may occur posttransradial intervention and limits the radial artery as a future access site, thus precluding its use as an arterial conduit. In this study, we investigate the incidence and factors influencing the RAO in the current literature.
  
  
  RESULTS
  We searched MEDLINE and EMBASE for studies of RAO in transradial access. Relevant studies were identified and data were extracted. Data were synthesized by meta-analysis, quantitative pooling, graphical representation, or by narrative synthesis. A total of 66 studies with 31 345 participants were included in the analysis. Incident RAO ranged between <1% and 33% and varied with timing of assessment of radial artery patency (incidence of RAO within 24 hours was 7.7%, which decreased to 5.5% at >1 week follow-up). The most efficacious measure in reducing RAO was higher dose of heparin, because lower doses of heparin were associated with increased RAO (risk ratio 0.36, 95% CI 0.17-0.76), whereas shorter compression times also reduced RAO (risk ratio 0.28, 95% CI 0.05-1.50). Several factors were found to be associated with RAO including age, sex, sheath size, and diameter of radial artery, but these factors were not consistent across all studies.
  
  
  CONCLUSIONS
  RAO is a common complication of transradial access. Maintenance of radial patency should be an integral part of all procedures undertaken through the radial approach. High-dose heparin along with shorter compression times and patent hemostasis is recommended in reducing RAO.
authors.affiliation: St. Helens & Knowsley Teaching Hospital (NHS) Trust, Whiston Hospital, Prescot, UK (M.R.) Keele Cardiovascular Research Group, University of Keele, Stoke-on-Trent, UK (M.R., C.S.K., M.A.M.).
authors.forename: Muhammad
authors.initials: M
authors.lastname: Rashid
authors.affiliation: Keele Cardiovascular Research Group, University of Keele, Stoke-on-Trent, UK (M.R., C.S.K., M.A.M.).
authors.forename: Chun Shing
authors.initials: CS
authors.lastname: Kwok
authors.affiliation: The Wright Center for Graduate Medical Education, The Commonwealth Medical College, Scranton, PA (S.P.).
authors.forename: Samir
authors.initials: S
authors.lastname: Pancholy
authors.affiliation: Artemis Hospital, Gurgaon, India (S.C.).
authors.forename: Sanjay
authors.initials: S
authors.lastname: Chugh
authors.affiliation: University Clinic of Cardiology Skopje, Skopje, Macedonia (S.A.K.).
authors.forename: Sasko A
authors.initials: SA
authors.lastname: Kedev
authors.affiliation: University Hospital and Faculty of Medicine Pilsen, Pilsen, Czech Republic (I.B.).
authors.forename: Ivo
authors.initials: I
authors.lastname: Bernat
authors.affiliation: Royal Stoke Hospital, University Hospital North Midlands Trust, Stoke-on-Trent, UK (K.R., A.L., J.N., M.A.M.).
authors.forename: Karim
authors.initials: K
authors.lastname: Ratib
authors.affiliation: Royal Stoke Hospital, University Hospital North Midlands Trust, Stoke-on-Trent, UK (K.R., A.L., J.N., M.A.M.).
authors.forename: Adrian
authors.initials: A
authors.lastname: Large
authors.affiliation: Manchester Heart Centre, Manchester Royal Infirmary, Manchester, UK (D.F.).
authors.forename: Doug
authors.initials: D
authors.lastname: Fraser
authors.affiliation: Royal Stoke Hospital, University Hospital North Midlands Trust, Stoke-on-Trent, UK (K.R., A.L., J.N., M.A.M.).
authors.forename: James
authors.initials: J
authors.lastname: Nolan
authors.affiliation: Keele Cardiovascular Research Group, University of Keele, Stoke-on-Trent, UK (M.R., C.S.K., M.A.M.) Royal Stoke Hospital, University Hospital North Midlands Trust, Stoke-on-Trent, UK (K.R., A.L., J.N., M.A.M.) Farr Institute, Institute of Population Health, University of Manchester, UK (M.A.M.).
authors.forename: Mamas A
authors.initials: MA
authors.lastname: Mamas
mesh_terms: D000368:Aged; D000925:Anticoagulants / Q000008:administration & dosage; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000453:epidemiology* / Q000503:physiopathology / Q000517:prevention & control; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D016009:Chi-Square Distribution; D004305:Dose-Response Relationship, Drug; D005260:Female; D006493:Heparin / Q000008:administration & dosage; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D016017:Odds Ratio; D011677:Punctures; D017534:Radial Artery / Q000503:physiopathology*; D012307:Risk Factors; D014661:Vasoconstriction
chemical_list: D000925:Anticoagulants; D006493:Heparin
keywords: radial artery occlusion; transradial catheterization or access; vascular complications
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