Abstract 13320: Vascular Dysfunction Due to Sheath Insertion Into the Radial Artery
Background: The transradial approach is widely used for coronary procedures. However, this procedure carries a risk of radial artery injury such as dissection, spasm and occlusion. We examined the vascular dysfunction caused by the transradial approach using reactive hyperemia peripheral arterial tonometry (RH-PAT), a recently used technique for evaluating endothelial function in digits, and compared the differences in injuries according to the size of sheath
Mehods: Forty-three patients receiving transradial catheterization with 4-Fr/5-Fr (non-6Fr; n = 26) sheaths or 6Fr sheaths (n = 17) were enrolled. RH-PAT was evaluated using Endo-PAT2000 in the arm of sheath placement and in the other arm as a control before, at the day and 6 months (n = 16, 6-Fr group; n = 13, non-6-Fr group) after catheterization.
Results: RH-PAT values decreased from 2.42 ± 0.67 before catheterization to 2.08 ± 0.41 at the day after catheterization in the 6-Fr group (p = 0.03), which was more evident in patients with a longer procedure time (> 90 minutes). On the other hand, the change in the non-6-Fr group was not significant. RH-PAT of control side was unchanged in both groups. At 6 months after catheterization, RH-PAT values in 6-Fr group had not completely returned to baseline.
Conclusions: The insertion of a 6-Fr catheter sheath into the radial artery, especially with a longer procedure time, impaired vascular endothelial function, which occurred at the day after the procedure and sustained after 6 months. Thus, we have to pay attention to the sheath size and procedure time at the transradial approach.
Author Disclosures: T. Nakata: None. S. Ikeda: None. S. Koga: None. Y. Koide: None. H. Kawano: None. K. Maemura: None.
- © 2015 by American Heart Association, Inc.