Comparison of acute and chronic non-sheathed radial artery injury between the first and repeat transradial intervention by optical coherence tomography

doi:10.3969/j.issn.1006-7795.2020.03.026

Abstract

Abstract: Objective To evaluate the acute and chronic effects of transradial intervention (TRI) on the non-sheathed radial artery (NSRA) by optical coherence tomography (OCT). Methods A total of 162 patients who underwent both OCT-guided TRI and NSRA OCT examination between February 2016 and September 2017 were enrolled. The patients were divided into the first TRI group (n=131) and the repeat TRI group (n=31). The incidence rate of acute injury including intimal tear, dissection, perforation, thrombus and spasm as well as the chronic injury indexes, including intimal area, percentage of lumen narrowing (%LN), intima-media ratio (IMR) and intimal thickness index (ITI), were compared between the two groups. Results The incidence of acute injury in NSRA was 31.5% in the repeat TRI group, significantly higher than that in the first TRI group (48.4% vs 27.5%, P=0.032). There was no significant difference in the incidence of intimal tear (6.5% vs 5.3%, P=1.000), dissection (9.7% vs 1.5%, P=0.075), perforation (3.2% vs 1.5%, P=1.000), thrombus (12.9% vs 6.9%, P=0.457), and spasm (29.0% vs 16.0%, P=0.094) between the two groups. Intimal area (0.59 mm² vs 0.46 mm², P=0.011), IMR (0.40 vs 0.28, P=0.001) and ITI (0.27 vs 0.22, P=0.012) of the patients in the repeat TRI group were significantly greater than those in the first TRI group, while%LN showed no difference (31.70% vs 30.81%, P=0.244). Multivariate Logistic regression analysis revealed that repeat TRI was an independent risk factor for acute NSRA injury (OR=2.772, 95%CI: 1.053-7.301, P=0.039). Conclusions The incidence of acute injury after TRI in NSRA was 31.5%. Compared with the first TRI group, the repeat TRI group has significantly higher incidence of acute injury and intimal hyperplasia. Repeat TRI is an independent risk factor for acute NSRA injury.

Key words: radial artery, sheath, coronary intervention, optical coherence tomography

CLC Number:

R540.4

Niu Dan, Hua Qi, Liu Zijing, Li Zixuan, Song Jiahui, Yan Rui, Wang Guozhong, Zhang Libin, Guo Jincheng. Comparison of acute and chronic non-sheathed radial artery injury between the first and repeat transradial intervention by optical coherence tomography[J]. Journal of Capital Medical University, 2020, 41(3): 464-469.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2020.03.026

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2020/V41/I3/464

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