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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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Buturak, A., Görgülü, Ş., Norgaz, T., Voyvoda, N., Şahingöz, Y., Değirmencioğlu, A., Demirci, Y., & Dağdelen, S. (2013) · Canadian Journal of Cardiology · doi:10.1016/j.cjca.2013.07.474 · Cited by 1
Chugh, Y., Chugh, S., Matsukage, T., & Chugh, S. K. (2017) · Indian Heart Journal · doi:10.1016/j.ihj.2017.01.008 · Cited by 1
Concept and practice of transradial 5 French percutaneous treatment of coronary bifurcation lesions
Sgueglia, G. A., Gioffrè, G., SANTIS, A. D., Piccioni, F., Summaria, F., Giorgio, A. D., D’Errico, F., & Gaspardone, A. (2018) · Catheterization and Cardiovascular Interventions · doi:10.1002/ccd.27844 · Cited by 1
Ahmadi, M., Bagheri, R. K., & Esfehani, R. J. (2018) · Europe PMC (PubMed Central) · doi:10.22122/arya.v14i5.1718 · Cited by 1
Khanra, D., Tiwari, P., Sinha, S., Aggrawal, P., & Soni, S. (2019) · Heart India · doi:10.4103/heartindia.heartindia_30_19 · Cited by 1
Duplex Ultrasound Imaging of the Radial Artery
Kistler, A., Hnath, J. C., Warner, C. J., Roddy, S. P., & Darling, R. C. (2022) · Springer eBooks · doi:10.1007/978-3-030-60626-8_31 · Cited by 1
Radial artery access for peripheral endovascular procedures
Bindra, S., Ghatas, M., Rajhans, A., & Ahn, S. S. (2022) · Italian Journal of Vascular and Endovascular Surgery · doi:10.23736/s1824-4777.21.01522-9 · Cited by 1
When size matters: Feasibility of using larger diameter radial catheters
Damluji, A. A., & Gilchrist, I. C. (2012) · Catheterization and Cardiovascular Interventions · doi:10.1002/ccd.24339 · Cited by 1
Slender Sheaths Have the Potential to Expand the Use of Transradial Access for Complex CTO-PCI
Aminian, A., Lalmand, J., & Iglesias, J. F. (2017) · JACC: Cardiovascular Interventions · doi:10.1016/j.jcin.2017.02.039 · Cited by 1
Access Sites for Vascular Interventions
Tomey, M. I., & Sanborn, T. A. (2014) · Springer eBooks · doi:10.1007/978-3-642-37393-0_68-1
Doble loop de arteria humeral en un paciente asintomático
Fernández-Caballero, D., Fernández-Heredero, Á., & Cubas, L. R.-D. (2009) · Hispana
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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