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Transradial coronary angiography (TRA) is associated with improved bleeding, vascular complication and mortality in acute coronary syndromes as compared to the transfemoral approach, but radial artery diameter (RAD) has not yet been systematically studied in a U.S. urban population using routine prospective forearm angiography (FAA).
Consecutive patients (pts) with FAA acquired during TRA from September 2015 to August 2016 were retrospectively analyzed. Quantitative radial angiography (QRA) was performed on digital subtracted angiograms. RAD measurements (in millimeters) at distal (dRAD), mid (mRAD), and proximal (pRAD) segments, as well as minimum (minRAD) and maximum (maxRAD) diameters were indexed to radial arterial sheath size and measured. RAD measurements were adjudicated by 2 expert operators. Descriptive statistics and regression analyses were performed using Stata15 (College Station, TX).
Of 175 FAA, 2 were excluded due to uninterpretable QRA. Clinical and radial artery characteristics are summarized (Table). Women had smaller RAD versus men at mRAD (2.87 vs. 3.04 mm, p=0.037), pRAD (3.11 vs. 3.33 mm, p=0.021), minRAD (2.36 vs. 2.59 mm, p=0.006), and maxRAD (3.32 vs 3.53 mm, p=0.0195). Univariate analysis showed correlation between minRAD and sex (p=0.012), age (p=0.019), and weight (p=0.008). However, after multivariate analysis, only sex was associated with minRAD (p=0.05).
This is the first study to describe the clinical determinants of RAD using prospective FAA in TRA in a U.S. population. Women had significantly smaller RAD across mid, proximal, minimum, and maximum segments. Sex was the only multivariate predictor of minRAD.