The Importance of Ankel-brachial Index in Prediction Vascular Complications in Transradial Access Procedures

Overview

Journal Sci Prog

Publisher Sage Publications

Specialty Science

Date 2024 Jun 14

PMID 38872465

Authors

Chuanwei Li

Wen Zhang

Jun Xiao

Chunyu Zeng

Chunmei Xu

Affiliations

Soon will be listed here.

Abstract

Objective: The study aimed to explore the predictors of vascular complications (VCs) associated with transradial access, as the occurrence and severity of these complications were found to be significantly lower compared to femoral access. However, it is important to note that the occurrence of these complications still has a negative impact on clinical outcomes. Nevertheless, there is limited available data on the predictors of complications specifically related to radial access.

Methods: A retrospective case-control study was conducted on individuals who underwent percutaneous coronary diagnostic or therapeutic procedures at Daping Hospital, following the inclusion and exclusion criteria. The study compared demographic characteristics, VC types, ankle brachial index (ABI), and severity of coronary artery stenosis between the two groups.

Results: We enrolled 300 subjects with VCs and 300 age- and sex-matched subjects without VCs as controls. There were no differences in the baseline characteristics or comorbidities between the groups. Compared to the control group, the VC group has a higher portion of left radial access (6.0%) and previous radial artery puncture history (29.7% vs. 18.3%, <0.001). The ABI was significantly lower than the non-VC group (1.17 ± 0.17 vs. 1.23 ± 0.14, <0.001). In the multivariate logistic regression analysis, several factors were found to be independently associated with the occurrence of VC. These factors include ABI (OR=0.060, 95% CI: 0.014-0.249, <0.001), the procedure being performed by junior operators (OR=1.892, 95% CI: 1.314-2.745, <0.001), and previous access on the same radial artery (OR=1.795, 95% CI: 1.190-2.707, <0.01).

Conclusions: Patients who exhibit a lower ABI and have a history of prior radial access procedures may be at an increased risk of developing radial access VC. Therefore, it is recommended to routinely measure ABI prior to these procedures, as it may serve as a predictive tool for assessing the risk of VC.

References

Antoneli F, Passos F, Lopes L, Briones M . A Kolmogorov-Smirnov test for the molecular clock based on Bayesian ensembles of phylogenies. PLoS One. 2018; 13(1):e0190826. PMC: 5754089. DOI: 10.1371/journal.pone.0190826. View

Taniguchi Y, Sakakura K, Tsukui T, Yamamoto K, Jinnouchi H, Seguchi M . Association of Ankle Brachial Index with Clinical Outcomes Following Percutaneous Coronary Intervention in Patients with Aortic Aneurysm. Intern Med. 2021; 60(17):2733-2740. PMC: 8479205. DOI: 10.2169/internalmedicine.6816-20. View

Murray G, Butcher I, Heald C, Lee R, Chambless L, Folsom A . Ankle brachial index combined with Framingham Risk Score to predict cardiovascular events and mortality: a meta-analysis. JAMA. 2008; 300(2):197-208. PMC: 2932628. DOI: 10.1001/jama.300.2.197. View

Jin C, Li W, Qiao S, Yang J, Wang Y, He P . Costs and Benefits Associated With Transradial Versus Transfemoral Percutaneous Coronary Intervention in China. J Am Heart Assoc. 2016; 5(4). PMC: 4843527. DOI: 10.1161/JAHA.115.002684. View

Tokarek T, Dziewierz A, Plens K, Rakowski T, Zabojszcz M, Dudek D . Radial Approach Expertise and Clinical Outcomes of Percutanous Coronary Interventions Performed Using Femoral Approach. J Clin Med. 2019; 8(9). PMC: 6780122. DOI: 10.3390/jcm8091484. View

Lin T, Chen T, Liu J, Tu X . Extending the Mann-Whitney-Wilcoxon rank sum test to survey data for comparing mean ranks. Stat Med. 2021; 40(7):1705-1717. DOI: 10.1002/sim.8865. View

Amin A, Patterson M, House J, Giersiefen H, Spertus J, Baklanov D . Costs Associated With Access Site and Same-Day Discharge Among Medicare Beneficiaries Undergoing Percutaneous Coronary Intervention: An Evaluation of the Current Percutaneous Coronary Intervention Care Pathways in the United States. JACC Cardiovasc Interv. 2017; 10(4):342-351. DOI: 10.1016/j.jcin.2016.11.049. View

Kim E, Song P, Yang J, Song Y, Hahn J, Choi J . Peripheral artery disease in korean patients undergoing percutaneous coronary intervention: prevalence and association with coronary artery disease severity. J Korean Med Sci. 2013; 28(1):87-92. PMC: 3546110. DOI: 10.3346/jkms.2013.28.1.87. View

Manly D, Karrowni W, Rymer J, Kaltenbach L, Swaminathan R, Messenger J . Characteristics and Outcomes of Patients With History of CABG Undergoing Cardiac Catheterization Via the Radial Versus Femoral Approach. JACC Cardiovasc Interv. 2021; 14(8):907-916. DOI: 10.1016/j.jcin.2021.01.053. View

10.

Han Y, Guo J, Zheng Y, Zang H, Su X, Wang Y . Bivalirudin vs heparin with or without tirofiban during primary percutaneous coronary intervention in acute myocardial infarction: the BRIGHT randomized clinical trial. JAMA. 2015; 313(13):1336-46. DOI: 10.1001/jama.2015.2323. View

11.

Aboyans V, Criqui M, Abraham P, Allison M, Creager M, Diehm C . Measurement and interpretation of the ankle-brachial index: a scientific statement from the American Heart Association. Circulation. 2012; 126(24):2890-909. DOI: 10.1161/CIR.0b013e318276fbcb. View

12.

Barbeau G, Arsenault F, Dugas L, Simard S, Lariviere M . Evaluation of the ulnopalmar arterial arches with pulse oximetry and plethysmography: comparison with the Allen's test in 1010 patients. Am Heart J. 2004; 147(3):489-93. DOI: 10.1016/j.ahj.2003.10.038. View

13.

Aminian A, Sgueglia G, Wiemer M, Kefer J, Gasparini G, Ruzsa Z . Distal Versus Conventional Radial Access for Coronary Angiography and Intervention: The DISCO RADIAL Trial. JACC Cardiovasc Interv. 2022; 15(12):1191-1201. DOI: 10.1016/j.jcin.2022.04.032. View

14.

Bryniarski K, Tokarek T, Bryk T, Rutka J, Gawlik I, Zabowka A . Intima-media thickness and ankle-brachial index are correlated with the extent of coronary artery disease measured by the SYNTAX score. Postepy Kardiol Interwencyjnej. 2018; 14(1):52-58. PMC: 5939545. DOI: 10.5114/aic.2018.74355. View

15.

Hashizume N, Miura T, Miyashita Y, Motoki H, Ebisawa S, Izawa A . Prognostic Value of Ankle-Brachial Index in Patients Undergoing Percutaneous Coronary Intervention: In-Hospital and 1-Year Outcomes From the SHINANO Registry. Angiology. 2017; 68(10):884-892. DOI: 10.1177/0003319717697883. View

16.

Lincoff A, Bittl J, Harrington R, Feit F, Kleiman N, Jackman J . Bivalirudin and provisional glycoprotein IIb/IIIa blockade compared with heparin and planned glycoprotein IIb/IIIa blockade during percutaneous coronary intervention: REPLACE-2 randomized trial. JAMA. 2003; 289(7):853-63. DOI: 10.1001/jama.289.7.853. View

17.

Zabojszcz M, Januszek R, Siudak Z, Janion-Sadowska A, Jedrychowska M, Pawlik A . Association between the mortality rate and operator volume in patients undergoing emergency or elective percutaneous coronary interventions. Kardiol Pol. 2020; 78(2):138-146. DOI: 10.33963/KP.15123. View

18.

Rakowski T, Wegiel M, Siudak Z, Plens K, Dziewierz A, Birkemeyer R . Prevalence and Predictors of Coronary Artery Perforation During Percutaneous Coronary Interventions (from the ORPKI National Registry in Poland). Am J Cardiol. 2019; 124(8):1186-1189. DOI: 10.1016/j.amjcard.2019.07.021. View

19.

Chong A, Lo T, George S, Ratib K, Mamas M, Nolan J . The effect of pre-procedure sublingual nitroglycerin on radial artery diameter and Allen's test outcome - Relevance to transradial catheterization. Cardiovasc Revasc Med. 2017; 19(2):163-167. DOI: 10.1016/j.carrev.2017.07.016. View

20.

von Elm E, Altman D, Egger M, Pocock S, Gotzsche P, Vandenbroucke J . The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies. Ann Intern Med. 2007; 147(8):573-7. DOI: 10.7326/0003-4819-147-8-200710160-00010. View