Best Practices for the Prevention of Radial Artery Occlusion After Transradial Diagnostic Angiography and Intervention

Transradial access (TRA) is increasingly used worldwide for percutaneous interventional procedures and associated with lower bleeding and vascular complications than transfemoral artery access. Radial artery occlusion (RAO) is the most frequent post-procedural complication of TRA, restricting the us...

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Bibliographic Details
Published in:JACC. Cardiovascular interventions 2019-11, Vol.12 (22), p.2235-2246
Main Authors: Bernat, Ivo, Aminian, Adel, Pancholy, Samir, Mamas, Mamas, Gaudino, Mario, Nolan, James, Gilchrist, Ian C., Saito, Shigeru, Hahalis, George N., Ziakas, Antonio, Louvard, Yves, Montalescot, Gilles, Sgueglia, Gregory A., van Leeuwen, Maarten A.H., Babunashvili, Avtandil M., Valgimigli, Marco, Rao, Sunil V., Bertrand, Olivier F.
Format: Article
Language:English
Subjects:
hemostasis
Life Sciences
radial artery occlusion
transradial
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Summary:Transradial access (TRA) is increasingly used worldwide for percutaneous interventional procedures and associated with lower bleeding and vascular complications than transfemoral artery access. Radial artery occlusion (RAO) is the most frequent post-procedural complication of TRA, restricting the use of the same radial artery for future procedures and as a conduit for coronary artery bypass graft. The authors review recent advances in the prevention of RAO following percutaneous TRA diagnostic or interventional procedures. Based on the available data, the authors provide easily applicable and effective recommendations to prevent periprocedural RAO and maximize the chances of access in case of repeat catheterization or coronary artery bypass grafting surgery. [Display omitted] •RAO remains the most frequent post-procedural complication of transradial access, restricting the use of the same radial artery for future procedures, as a conduit for coronary artery bypass grafting or for arteriovenous fistula creation in patients requiring hemodialysis.•The real-world reported incidence of RAO remains high, with wide variability in the uptake of RAO prevention strategies.•The paper reviews the main recent advances in the field of RAO prevention and provides a series of expert recommendations to prevent RAO.•This consensus document is meant to provide guidance to increase the adoption of simple and effective methods to achieve an institutional rate of RAO 
ISSN:1936-8798
1876-7605
DOI:10.1016/j.jcin.2019.07.043