Duplex ultrasonographic assessment of the left distal radial artery in pre and post transradial coronary angiography.
Project no. 20677 · Status: Kapanmış · 2019
Summary
Introduction: Left distal radial artery (LDR) has proven feasibility as an alternative radial approach in coronary angiography procedures. We aimed to determine the changes of duplex ultrasonographic (USG) parameters of LDR and main radial arteries (LR) in pre and post transradial catheterization period. Methods: A prospective analysis of LR and LDR USG was conducted from September to December 2019. Overall, 100 patients admitted for elective left distal transradial coronary angiography were consecutively enrolled. Duplex analysis assessed on admission were repeated 24 hours post-catheterization. Results: The basal systolic diameter of both the LR and LDR was found as 2.38±0.38 vs 2.21±0.38mm (p=0.002). This increased to 2.75±0.47 and 2.4±0.46 mm 24 hours following catheterization (p<0.001). Pik systolic velocity and flow volume were higher in the LDR with no statistical significance. Stiffness index of the LDR was found higher than the LR (3.03±2.63 vs 2.27±2.51 p=0.039). It increased much more in the LR than the LDR following catheterization (pre 2.30±2.53 post 3.51±3.37 p=0.004 vs pre: 3.07±2.68 post 3.05±2.83 p=0.965). The LR had a higher distensibility than the LDR (14.77±10.93 vs 10.83±7.49 p=0.003). Following catheterization, it was decreased in the LR with a preservation in the LDR (pre 14.77±10.93 post 9.3±6.44 p<0.001; pre 10.83±7.49 post 11.44±9.8 p=0.556). Four occlusions were noticed in the LDR where 2 of them were extended to the LR artery. Conclusion: LDR is smaller and shows higher stiffness index with lower distensibility than the LR artery. Following catheterization, these parameters show preservation in the LDR, despite an impairement in the LR artery. Studies comparing main and distal radial access sites will be needed to accurately assess the change of stiffness parameters and provide new knowledge on vascular structure behavior together with more efficiency in preventing vascular complications following catheterization.