Transradial access (TRA) for a percutaneous coronary procedure can be achieved multiple times in a patient, with some patients having 10 or more successful procedures. Abdelaal et al identified factors associated with failure of repeated TRA. The authors are from the Quebec Heart-Lung Institute and Laval University in Quebec.
Outcome: failure to achieve access, which was usually due to radial artery occlusion (RAO). Signs of radial artery occlusion include weak pulse, low pulse oximetry or failed puncture.
Predictors for failure in transradial access (TRA):
(1) female gender (odds ratio 3.1)
(2) prior coronary artery bypass graft (CABG; odds ratio 5.3)
(3) repeat radial access (odds ratio 2.1)
A rough estimate of the failure rate for repeated radial access is 5% for each access after the first.
estimated failure rate =
= 5% * (number of previous access procedures)
Interventions to preserve the radial artery can be important for a patient requiring multiple coronary percutaneous procedures.
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