Relationship between Radial Artery Diameters with Incidence of Radial Artery Occlusion after Transradial Coronary Catheterization: An Observational Cohort Study

Background: Radial artery Occlusion (RAO) is a potential complication of transradial coronary catheterization procedures. The association between radial artery diameter and the risk of RAO remains controversial, with conflicting findings reported in previous studies. Objectives: To investigate the relationship between radial artery diameter with incidence of radial artery occlusion after transradial coronary catheterization and to assess the independent predictive value of radial artery diameter for RAO. Methods: This prospective, observational cohort study enrolled 300 patients undergoing transradial coronary angiography or percutaneous coronary intervention at a single center. Radial artery diameter was measured using a standardized ultrasound protocol before the procedure. Radial artery patency was assessed immediately after the procedure and at a 24-48 hour follow-up visit, with RAO defined as the absence of detectable blood flow on Doppler ultrasound. Multivariate logistic regression analysis was performed to evaluate the independent association between radial artery diameter and RAO, adjusting for potential confounders. Results: Radial artery occlusion occurred in 38 patients (12.7%). Patients with a small radial artery diameter (<2.5mm) had a significantly higher incidence of RAO (24.0%) compared to those with a larger radial artery diameter (6.7%) (p=0.003). On multivariate analysis, small radial artery diameter (OR 3.24, 95% CI: 1.52-6.91, p=0.002) and larger sheath size (OR 1.85 per 1 Fr increase, 95% CI: 1.21-2.83, p=0.005) were independent predictors of RAO. Conclusions: Smaller radial artery occlusion following transradial coronary catheterization procedures. Radial artery diameter is significantly associated with an increased risk of radial artery assessment may help identify patients at higher risk for RAO and guide personalized decision-making regarding vascular access site selection and procedural techniques.