Open AccessChronic radial artery occlusion does not cause exercise induced hand ischemia
Author(s) -
van der Heijden Dirk J.,
van Leeuwen Maarten A.H.,
Ritt Marco J.P.F.,
van de Ven Peter M.,
van Royen Niels
Publication year - 2018
Publication title -
journal of interventional cardiology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.764
H-Index - 51
eISSN - 1540-8183
pISSN - 0896-4327
DOI - 10.1111/joic.12552
Subject(s) - medicine , ischemia , radial artery , occlusion , cardiology , perfusion , artery , surgery
Objectives The aim of the study was to evaluate the occurrence of hand ischemia in patients with radial artery occlusion (RAO), using the contralateral hand as control. Background Radial artery occlusion is a common complication (6%) after transradial access (TRA) but rarely leads to major ischemic events due to the collateral perfusion of the hand. However, it has been reported that RAO can become symptomatic, possibly as a consequence of hand ischemia. To evaluate the existence of exercise induced hand ischemia in patients with RAO, we initiated the present study. Methods After a transradial coronary procedure, patients with suspicion of RAO were asked for study participation. After informed consent, radial ultrasound was performed. In patients with confirmed RAO, rest perfusion of the digits was analyzed by laser Doppler digital imaging. Occurrence of ischemia during exercise was assessed with transcutaneous oxygen pressure (TcPO2) and thumb capillary lactate. All analyses were performed in both the RAO side as well as the contralateral side as control. Results RAO occlusion was confirmed in 18 patients. After 5 min of exercise there were no significant differences in TcPO2 (51.4 mmHg [±17.2] vs 43.9 mmHg [±15.5], P = 0.18) or lactate (2.0 mmol/L [±0.7] vs 2.1 mmol/L [±0.7], P = 0.80) between RAO side and control side. Differences in mean TcPO2 were found to be stable during exercise and not different from baseline differences. Conclusions Chronic radial artery occlusion does not lead to exercise induced hand ischemia.