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Radial Artery Occlusion After Transradial Interventions: A Systematic Review and Meta-Analysis

M. Rashid, CS. Kwok, S. Pancholy, S. Chugh, SA. Kedev, I. Bernat, K. Ratib, A. Large, D. Fraser, J. Nolan, MA. Mamas,

. 2016 ; 5 (1) : . [pub] 20160125

Jazyk angličtina Země Anglie, Velká Británie

Typ dokumentu časopisecké články, metaanalýza, přehledy

Perzistentní odkaz   https://www.medvik.cz/link/bmc17000574

BACKGROUND: Radial artery occlusion (RAO) may occur posttransradial intervention and limits the radial artery as a future access site, thus precluding its use as an arterial conduit. In this study, we investigate the incidence and factors influencing the RAO in the current literature. METHODS AND RESULTS: We searched MEDLINE and EMBASE for studies of RAO in transradial access. Relevant studies were identified and data were extracted. Data were synthesized by meta-analysis, quantitative pooling, graphical representation, or by narrative synthesis. A total of 66 studies with 31 345 participants were included in the analysis. Incident RAO ranged between <1% and 33% and varied with timing of assessment of radial artery patency (incidence of RAO within 24 hours was 7.7%, which decreased to 5.5% at >1 week follow-up). The most efficacious measure in reducing RAO was higher dose of heparin, because lower doses of heparin were associated with increased RAO (risk ratio 0.36, 95% CI 0.17-0.76), whereas shorter compression times also reduced RAO (risk ratio 0.28, 95% CI 0.05-1.50). Several factors were found to be associated with RAO including age, sex, sheath size, and diameter of radial artery, but these factors were not consistent across all studies. CONCLUSIONS: RAO is a common complication of transradial access. Maintenance of radial patency should be an integral part of all procedures undertaken through the radial approach. High-dose heparin along with shorter compression times and patent hemostasis is recommended in reducing RAO.

Citace poskytuje Crossref.org

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