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Role of vascular ultrasound scanning in repeated trans‐radial coronary artery intervention (prospective randomized study)
Author(s) -
Elmahdy Mahmoud Farouk,
Hassan Mohamed,
Elguindy Ahmed
Publication year - 2018
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.27413
Subject(s) - medicine , repeated measures design , radial artery , vascular access , ultrasound , analysis of variance , artery , cardiology , prospective cohort study , radiology , hemodialysis , statistics , mathematics
Objectives We aimed to detect if pre‐procedure vascular ultrasound scanning (VUS) of radial arteries (RAs) can increase the radial access success (RAS) rate and/or reduce the vascular access time (VAT), by guiding the choice of the proper access site for repeated trans‐radial interventions (TRIs). Background Currently, repeated‐TRIs are encountered more frequently in most of the cath. labs. However, structural changes of the RAs after TRA may hinder it is usage for repeated‐TRI. VUS is the most accurate noninvasive test for assessing RAs, nonetheless, its role in the setting of repeated‐TRIs has not been studied before. Material and methods We randomly assigned 300 patients undergoing repeated‐TRI, to either planning the vascular access site based upon the result of VUS that was performed pre‐procedural (group A, 150 patients) or to be left to the operator's discretion (group B, 150 patients). Results In group A (143/145 [98.6%]), RAS rate was only numerically higher than group B (143/150 [95.3%]), P = 0.08. There was a statistically significant differences between both groups in VAT [(1.25 ± 0.17 min), vs. (4.95 ± 0.87 min) for group A and B, respectively, P = 0.02] and in procedure duration [(37.2 ± 19.8 min) vs. (51.8 ± 18.6 min) for group A and B, respectively, P = 0.04]. RA spasm was more common in group B [18% (27/150)] than group A [2% (3/145)], P = 0.001. Conclusion VUS of RAs prior to repeated‐TRI is associated with significant reduction in VAT, procedure duration, RA spasm and a mild increase in the RAS rate.