Nerve Injury, Radial Artery Occlusion
Conditions
Keywords
Invasive coronary angiography, Distal transradial arterial access, Anatomical snuffbox, dTRA, dRA, Distal radial, Radial artery occlusion
Brief summary
Traditionally, coronary angiograms are performed through the radial artery which is accessed above the palm of the 'right' hand. In recent years, some cardiologists are performing this procedure from the back of the wrist in as the radial artery courses through the anatomical snuffbox (distal radial access). The aim of this study is to determine the prevalence of hand dysfunction following coronary angiography via the distal radial artery.
Detailed description
In this multi centre observational registry, we will recruit patients undergoing planned invasive coronary angiography. Inclusion criteria include: 1. Age ≥ 18 years. 2. The distal radial artery must be palpable and non-occlusive flow must be confirmed by Doppler ultrasound. 3. Patient should be able to comply with the protocol. 4. Provide written informed consent before study participation. The primary endpoint is the overall prevalence of hand dysfunction defined as any significant reduction from baseline score in any of the following five domains: DASH score Levine Katz score VAS score Sensory function Pinch grip strength. Specifically hand function will be assessed at 4 time points using simple tests of hand strength, sensation and ultrasound to assess the arterial latency.
Interventions
None listed
Sponsors
MC Zuiderzee
NHS National Waiting Times Centre Board
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
1. Age ≥ 18 years. 2. The distal radial artery must be palpable and non-occlusive flow must be confirmed by Doppler ultrasound. 3. Patient should be able to comply with the protocol. 4. Provide written informed consent before study participation.
Exclusion criteria
1. Obligatory femoral or forearm radial access 2. Previous ipsilateral forearm radial artery occlusion. 3. Undergoing another procedure involving the ipsilateral radial artery, performed between the index procedure and the follow-up date. 4. Enrolment in another study that competes or interferes with this study. 5. Poor clinical condition like cardiogenic shock, that prohibits pre- and postprocedural function tests. 6. Any other condition which, in the opinion of the investigator or operator, may pose a significant hazard to the subject if he or she is enrolled in the study. 7. Co-morbidity that excludes patient follow-up.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Prevalence of hand dysfunction | 1 month | Any significant deterioration from baseline in hand function according to the 5 studied domains. |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Vascular access complications (other than occlusion and bleeding) | Day 0 | Surgical complications or clinically important vascular access complications |
| Puncture time | Day 0 | Time from skin puncture to successful placement of wire into the artery |
| Success of distal radial access | Day 0 | Successful introduction of sheath |
| Fluoroscopy time | Day 0 | Minutes |
| Hemostasis duration | Day 0 | Minutes |
| Radial artery occlusion - including level of occlusion (prox/distal) | 0-12 months | USS guide |
Countries
United Kingdom
Outcome results
None listed