The Correlated Factor Study On Acute Radial Artery Occlusion(RAO) After Transradial Coronary Interventional Procedures

Objective: To study the factors and prevention measure for acute radial arteryocclusion(RAO) after transradial coronary interventional procedures.Methods:486cases who having transradial coronary intervention from M ar.2011to Oct.2011in our hospital were selected,There are278male and208female patientswith average age of59.2±12.1. the patients who were underwent transradial coronaryintervention were tested with two methods to diagnose RAO in3days：by using thedirect palpation right radial artery pulsation method, such as no pulsation, judged asRAO, such as pulsatility is weak, for radial artery color Doppler examination,according to the radial artery puncture point near a forward flow, determining whetheror not there is RAO. Combined with clinical data, All of them were divided intonormal group and RAO group according to whether they had RAO．Risk factors ofRAO were analyzed by logistic regression model．Results:1、The36cases were identified RAO of486patients（7.20%）,There are21male and14female patients with average age of57.1±13.5．This study found that the radialartery occlusion in35cases,33cases of asymptomatic radial artery occlusion, only2cases of ischemic symptoms, of which1case v. the thumb and index finger to feel abit numb, l cases of ipsilateral hand skin temperature is slightly lower, were not foundon the contralateral upper extremity symptoms of severe ischemia．2、We found32radial artery occluded cases by touching pulse，that the9cases theright radial artery decreased significantly in patients with color Doppler imaging, afterinspection, found in3cases for radial artery occlusion, the blood flow come fromthe right ulnar artery collateral circulation of small flow, the remaining6patients ofradial artery in forward flow．3、There were no significant changes of gender,hypertension,histoyof TRI, carotidplaque,post—procedure duration of high-pressure compression hemostais, but therewere significant changes of diabetes, smoking, hyperlipidemia, coronary lesions，position of puncture to the stylion radiale distance(>2.0cm), times of puncturation，Heparin dose（>5000Iu）．Multiple regression analysis showed that severmulti-coronary lesions，Position of puncture to the stylion radiale distance(>2.0cm), times of puncturation，Heparin dose（>5000Iu）were the main determinants for radialartery occlusion．4．In simple transradial coronary angiography of patients, although the incidence ofRAO in3000Iu and2000Iu heparin heparin dose between the two groups had nosignificant difference (P>0.05), but3000Iu heparin group of radial artery patencyrate higher than2000IU heparin group, the incidence of RAO below2000Iu heparingroup．Conclusion:1．Coronary artery lesions，Position of puncture to the stylion radiale distance(>2.0cm), times of puncturation，Heparin dose（>5000Iu）were the main determinants forradial artery occlusion．2．Ultrasonic diagnosis is better than touching pulse．Especially the patients of theradial artery pulse weakness，ultrasonic diagnosis mode reduced missing diagnosis．3．Percutaneous radial artery approach for coronary angiography, patients given3000IU heparin may help to reduce the occurrence of RAO.