Periprocedural Use of Heparin and Other Factors Contributing to the Patency of the Radial Artery Following Diagnostic Coronary Angiography

<b>Background:</b> Diagnostic angiography of coronary arteries is one of the most common procedures in invasive cardiology and is mainly performed via the radial artery. Rapid improvements in the quality of the equipment and operator's experience have changed the landscape of this procedure. <b>Methods:</b> In this study, 284 patients were analyzed to determine whether heparin administration should be a necessity for all patients to prevent radial artery occlusion (RAO). Moreover, the possible influence of 51 other factors on RAO was analyzed. <b>Results:</b> This study revealed that heparin administration does not have a significant impact on RAO incidence (<i>p</i> = 0.131). However, it was found that a longer fluoroscopy time (<i>p</i> < 0.001) and smaller (5F) vascular sheath (<i>p</i> = 0.001) might serve as protective factors against RAO. On the other hand, a greater number of catheters (<i>p</i> < 0.001), greater compression time (<i>p</i> = 0.001), wider (6F) vascular sheath (<i>p</i> = 0.002), spasm occurrence (<i>p</i> = 0.001), spasmolytic administration (<i>p</i> < 0.001) and atherosclerotic changes in the radial artery (<i>p</i> = 0.005) were risk factors for RAO. <b>Conclusions:</b> This study demonstrates the need for a more personalized approach to the patient when analyzing the individual risk of RAO. In our opinion, it is possible to omit heparin in cases of patients with an initial low risk of RAO or possible adverse drug reactions during diagnostic angiography.

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Journal
Journal of Clinical Medicine
Published
2025-02-20
DOI
https://doi.org/10.3390/jcm14051401
Primary Topic
Vascular Procedures and Complications
Type
article
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0.00

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article

Periprocedural Use of Heparin and Other Factors Contributing to the Patency of the Radial Artery Following Diagnostic Coronary Angiography

Maciej Podolski, Tomasz Bochenek, Jan Szczogiel, Adam Pytlewski et al.
Journal of Clinical Medicine
Vascular Procedures and Complications
article

Periprocedural Use of Heparin and Other Factors Contributing to the Patency of the Radial Artery Following Diagnostic Coronary Angiography

Maciej Podolski, Tomasz Bochenek, Jan Szczogiel, Adam Pytlewski, A Jaklik, Katarzyna Mizia­‐Stec, Marek Grabka, Michał Lelek, Bartosz Gruchlik
article en

Abstract

<b>Background:</b> Diagnostic angiography of coronary arteries is one of the most common procedures in invasive cardiology and is mainly performed via the radial artery. Rapid improvements in the quality of the equipment and operator's experience have changed the landscape of this procedure. <b>Methods:</b> In this study, 284 patients were analyzed to determine whether heparin administration should be a necessity for all patients to prevent radial artery occlusion (RAO). Moreover, the possible influence of 51 other factors on RAO was analyzed. <b>Results:</b> This study revealed that heparin administration does not have a significant impact on RAO incidence (<i>p</i> = 0.131). However, it was found that a longer fluoroscopy time (<i>p</i> < 0.001) and smaller (5F) vascular sheath (<i>p</i> = 0.001) might serve as protective factors against RAO. On the other hand, a greater number of catheters (<i>p</i> < 0.001), greater compression time (<i>p</i> = 0.001), wider (6F) vascular sheath (<i>p</i> = 0.002), spasm occurrence (<i>p</i> = 0.001), spasmolytic administration (<i>p</i> < 0.001) and atherosclerotic changes in the radial artery (<i>p</i> = 0.005) were risk factors for RAO. <b>Conclusions:</b> This study demonstrates the need for a more personalized approach to the patient when analyzing the individual risk of RAO. In our opinion, it is possible to omit heparin in cases of patients with an initial low risk of RAO or possible adverse drug reactions during diagnostic angiography.

Journal of Clinical MedicineVol. 14(5)
Medical University of Silesia (PL)
Śląski Uniwersytet Medyczny w Katowicach, Uniwersytet Śląski w Katowicach
Good health and well-being
Openalex Percentile: Top 95%
Vascular Procedures and Complications
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