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As there is growing interest in US for trans-radial angioplasty we want to see the feasibility, safety, success and complications of repeat radial artery route for coronary procedures.
Methods and Results
We retrospectively analyzed the data of patients who undergone repeat coronary through same radial artery route from Jan 2012 to Dec 2012 by two experienced operators from our institute. 137 patients undergone repeat same radial artery route for 161 coronary procedures with mean age of 54.2 ± 9.7 yrs and 21 females. Average procedure time for CAG was 8’ 45” and for was PCI 19’ 36” (excluding CTOs) . Average amount of contrast used for CAG was 45.2±15.6 ml and for PCI was 72±36.4ml. Maximum number of times in a pt transradial route used were 5. As this is nonrandomized study the same pt might have undergone CAG and PTCA either transradially or transfemorally over a period of time during the coronary procedures. Coronary procedures done through transradial route in a given pt were CAG+PTCA, CAG+CAG, PTCA+PTCA and MULTIPLE (>2 punctures) PROCEDURES . The no of pt, the mean of duration (days) between two transradial routes (minimum & maximum days) and success of procedure, in CAG+PTCA group of pts were 86, 168.3 and 100%, in CAG+CAG group of pts were 16, 667.2 and 100%, in PTCA+PTCA group of pts were 17, 751.9 and in multiple procedures group of pts 18, 328.1 respectively. Acute failures and/or complications concerned with transradial route occurred in 8 (10.9%) pts. No hematomas or infection or aneurysms at puncture site. In one pt (1.37%) we could not puncture radial artery, in one pt (1.37%) after arterial puncture wire passage was difficult, in two pts radial spasm, but relived with vasodilators & completed the PCI transradially (2.7% to nil) and in one pt (1.37%) guide support was not proper. Asymptomatic acute pulse occlusion in 3, but reappearance of pulse at 15 days in two of them (4.1% to 1.37%). Total failures were 4.1% (3 pts) and complications were 1.37% (one pt). So, overall failures and/or complications were 5.4% (4 pts). Failures and/or complications related to PCI occurred in 7 (9.59%) pts. Failures are mainly not able to cross the lesion (3 CTOs - 4.1%). In one CTO (1.37%) balloon could not be negotiated and in one calcific lesion (1.37%) stent could not be deployed. One pt (1.37%) developed mild CIN which improved with hydration. One pt (1.37%) developed acute stent thrombosis, repeat successful PCI done transradially.
Repeated transradial coronary procedures are safe with minimal complication and excellent success rates.