Evaluation of clinical effectiveness of retrograde recanalization of occluded radial artery via distal transradial approach
10.3969/j.issn.1004-8812.2025.03.003
- VernacularTitle:经远端桡动脉入路逆向开通闭塞桡动脉的临床效果评价
- Author:
Xiao-fei XIE
1
;
Sheng-xin ZUO
1
;
Jin-peng XU
1
;
Xiao-liang HAN
1
;
Gang-cheng SUN
1
;
Liang LI
1
Author Information
1. 安徽省胸科医院心血管内科,安徽 合肥 230000
- Publication Type:Journal Article
- Keywords:
Coronary heart disease;
Percutaneous coronary intervention;
Radial artery occlusion;
Distal transradial approach;
Retrograde opening
- From:
Chinese Journal of Interventional Cardiology
2025;33(3):135-140
- CountryChina
- Language:Chinese
-
Abstract:
Objective Radial artery occlusion(RAO)is one of the common complications following coronary intervention via the traditional radial artery approach.This study aims to evaluate the clinical effectiveness of retrograde recanalization of occluded radial arteries through the distal transradial approach(dTRA)approach.Methods A total of 35 patients with RAO admitted to the cardiovascular department of the Anhui Chest hospital between December 2022 and April 2024,who were scheduled to undergo coronary intervention and had attempted recanalization of RAO via dTRA approach were selected.The primary result was the success rate of recanalizing RAO via dTRA.The secondary results included factors influencing the failure of recanalization via dTRA,postoperative puncture complications,and the patency rate at the 3-month follow-up.Results This study divided the patients into a successful group(29 cases,82.9％)and a failed group(6 cases,17.1％)based on whether the distal radial artery was successfully opened and occluded.The proportion of smoking(100.00％vs.17.24％,P=0.040),history of diabetes(100.00％vs.10.34％,P=0.025),and chronic total occlusion of coronary artery(83.33％vs.17.24％,P=0.030)in the failure group were higher than those in the success group,and the difference was statistically significant.The application rate of balloon tracking assisted technology in the failed group(16.67％vs.58.62％,P=0.045),and the diameter of the radial artery at 3 days after surgery[(1.63±0.13)mm vs.(2.13±0.32)mm,P=0.021]and the peak radial artery blood flow velocity at 3 days postoperatively[(0.10±0.78)m/s vs.(0.50±0.13)m/s,P＜0.001]were all lower in the successful group,and the differences were statistically significant.Logistic regression analysis 3 days after surgery showed that chronic complete occlusion of the coronary artery was an independent risk factor for surgical opening failure(OR 0.042,95％CI 0.004-0.438,P=0.008).After 3 months of follow-up,the patency rate of the successful group was 55.2％.Conclusions Retrograde recanalization of RAO via dTRA is safe and feasible,but its long-term patency rate is not high.
