title: Long-Term Radial Artery Patency Following Transradial Coronary Catheterization via a 7-Fr Sheath.
abstract: BACKGROUND
  Radial artery occlusion (RAO) may occur following transradial catheterization, precluding future use of the vessel for vascular access or as a coronary bypass graft. Recanalization of RAO may occur; however, long-term radial artery patency when revascularization is more likely to be required has not been investigated. Transradial catheterization is usually performed via 5-Fr or 6-Fr catheters. Insertion of 7-Fr sheaths into the radial artery enables complex coronary interventions but may increase the risk of RAO.
  
  
  OBJECTIVE
  To assess the long-term radial artery patency following transradial catheterization via 7-Fr sheaths.
  
  
  METHODS
  Antegrade radial artery blood flow was assessed by duplex ultrasound in 43 patients who had undergone transradial catheterization via a 7-Fr sheath.
  
  
  RESULTS
  All patients had received intravenous unfractionated heparin with a mean activated clotting time (ACT) of 247 ± 56 seconds. Twenty-four patients (56%) had received a glycoprotein IIbIIIa inhibitor and no vascular site complications had occurred. Mean time interval from catheterization to duplex ultrasound was 507 ± 317 days. Asymptomatic RAO was documented in 8 subjects (19%). Reduced body weight was the only significant univariate predictor of RAO (78 ± 11 vs. 89 ± 13 kg, P = 0.031). In a bivariate model using receiver operator characteristic (ROC) curves, the combination of lower weight and shorter ACT offered best prediction of RAO (area under the ROC curve 0.813).
  
  
  CONCLUSIONS
  Asymptomatic RAO was found at late follow-up in approximately 1 of 5 patients undergoing transradial catheterization via a 7-Fr sheath and was associated with lower body weight and shorter ACT.
authors.forename: Dan
authors.initials: D
authors.lastname: Levin
authors.forename: Salim
authors.initials: S
authors.lastname: Adawi
authors.forename: David A
authors.initials: DA
authors.lastname: Halon
authors.forename: Avinoam
authors.initials: A
authors.lastname: Shiran
authors.forename: Ihab
authors.initials: I
authors.lastname: Asmer
authors.forename: Ronen
authors.initials: R
authors.lastname: Rubinshtein
authors.forename: Ronen
authors.initials: R
authors.lastname: Jaffe
mesh_terms: D000368:Aged; D001157:Arterial Occlusive Diseases / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology / Q000503:physiopathology; D058070:Asymptomatic Diseases; D006328:Cardiac Catheterization / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D005260:Female; D006801:Humans; D007557:Israel / Q000453:epidemiology; D000069451:Long Term Adverse Effects / Q000209:etiology / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D017534:Radial Artery / Q000473:pathology / Q000503:physiopathology; D018616:Ultrasonography, Doppler, Duplex / Q000379:methods; D062666:Vascular Access Devices / Q000009:adverse effects*; D014654:Vascular Patency