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Anatomical consideration of the radial artery for transradial coronary procedures: arterial diameter, branching anomaly and vessel tortuosity
Abstract
Background The radial artery is currently regarded as a useful vascular access site for coronary procedures. Adequate anatomical information of the radial artery should be helpful in performing the transradial coronary procedure. Therefore, we tried to evaluate the size of radial artery, the incidence and clinical significance of anomalous branching patterns and tortuosity of the radial artery related with transradial coronary procedure.Materials and method In 1191 cases, mean radial arterial diameter (RAD) was measured before and after the procedure using a two-dimensional ultrasound and retrograde radial artery angiography was performed before the transradial coronary procedure in all patients. Branching anomaly, tortuosity of the radial artery and procedural characteristics including procedure times and local vascular complications were analyzed.Results The mean RAD was 2.60 +/- 0.41 mm by two-dimensional ultrasound: 2.69 +/- 0.40 mm in men and 2.43 +/- 0.38 mm in women (p < 0.001). Radial artery occlusion occurred in 0.6% in coronary angiography and 1.4% in coronary intervention. In multivariate analysis, coronary intervention was significantly related to the radial artery occlusion (p = 0.048). Anomalous branching of upper extremity artery was found in 38 cases (3.2%); high origin of the radial artery was most frequent in 28 cases (2.4%). Tortuosity of radial and brachial artery was found in 67 of 50 cases (4.2%). Most common forms of tortuosity were S-shape in 21 cases (31.3%) and Omega-shape in 21 cases (31.3%). And most common site of radial artery tortuosity was proximal third of antecubital fossa (35 cases, 52.2%). Prolonged procedure times and cross-overs to other arteries were related with tortuosity of the radial artery, but not with anomalous branching.Conclusion In our study, radial artery diameter was larger than the outer diameter of 5Fr sheath in 82.7% for transradial coronary procedure. Radial artery occlusion was associated with coronary intervention using larger size sheath than diagnostic angiography using 5Fr sheath. The incidence in branching anomaly and tortuosity of radial artery was not rare in our study. Radial artery tortuosity was associated with old age and prolonged procedure time.
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“The window of the pulsewave sensor is designed as 6 mm × 6 mm, capable to cover the radial artery sufficiently by having twice larger width than the radial artery diameter of 2.19–3.01 mm55.”
From A Flexible and Wearable Human Stress Monitoring Patch (2016) · cites this paper as [55]
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Transradial access for arteriovenous fistuloplasty in Singapore
Ong, C. W., Yong, E., Hong, Q., Chandrasekar, S., Quek, L. H. H., Pua, U., Tan, G. W. L., & Lo, Z. J. (2020) · The Journal of Vascular Access · doi:10.1177/1129729820946643 · Cited by 11
Transradial Sheathless Approach for PCI
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Effect of transient ulnar artery compression on radial artery diameter
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Balloon-assisted tracking technique as ‘a way forward’ for transradial intervention
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Distal radial artery: The last extreme rescue arterial access for interventional radiologists?
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Management of the access site after transradial percutaneous procedures
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Metadata
- Authors
- Yoo, B.-S., Yoon, J., Ko, J.-Y., Kim, J.-Y., Lee, S.-H., Hwang, S.-O., & Choe, K.-H.
- Affiliations
- Yonsei University (KR)
- Venue
- International Journal of Cardiology
- Publisher
- Elsevier BV
- Published
- 2005-06
- Volume
- 101
- Issue
- 3
- Pages
- 421-427
- ISSN
- 0167-5273 (ISSN-L)
- OpenAlex
- W2065778099
- Cited by
- 237
- References
- 22
- Citations by year
- 2026: 5 · 2025: 8 · 2024: 7 · 2023: 7 · 2022: 14 · 2021: 11 · 2020: 20 · 2019: 11 · 2018: 11 · 2017: 17 · 2016: 14 · 2015: 21 · 2014: 8 · 2013: 20 · 2012: 21
- FWCI
- 3.04
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- International Journal of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Vascular Procedures and Complications
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Coronary Interventions and Diagnostics
- Health Sciences › Medicine › Critical Care and Intensive Care Medicine › Central Venous Catheters and Hemodialysis
- Keywords
- radial artery, transradial access, coronary intervention, coronary angiography, arterial diameter, radial artery occlusion, vascular complications, antecubital fossa, procedure time, sex differences
- MeSH terms
- Catheterization, Peripheral, Female, Humans, Male, Middle Aged, Retrospective Studies, Ultrasonography, Reproducibility of Results, Coronary Angiography, Myocardial Ischemia, Radial Artery
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