Complications of repeated transradial artery access for coronary angiography: a prospective cohort study

Radial artery access is preferred for coronary angiography due to reduced bleeding risk and faster recovery; however, the safety of repeated access through the same artery remains uncertain. This study aimed to describe the incidence of complications including occlusion, spasm, and dissection associated with repeated transradial catheterization. This prospective cohort study included 52 patients undergoing a repeat transradial procedure at a single center in Iran (2022–2023). The mean age was 58.46 ± 9.90 years, with 63.5% male. At follow-up ultrasound (median 90 days, IQR: 60–120 days), arterial occlusion was detected in 8 patients (15.4%; 95% CI: 8.0–27.5%). Intraprocedural radial artery spasm occurred in 5 patients (9.6%; 95% CI: 4.2–20.6%) and dissection in 1 patient (1.9%; 95% CI: 0.3–10.1%). No cases of aneurysm or hematoma were reported. Follow-up colour Doppler ultrasound revealed normal findings in 84.6% of patients. Procedural success via radial access was achieved in 98.1% of cases, with one crossover to femoral access due to severe spasm. In exploratory analyses, no significant associations were found between complications and patient demographics or procedural factors, though the study was underpowered for these comparisons.