Radial-brachial-subclavian axis anomalies in patients undergoing transradial coronary interventions

摘要

Background: Anomalies of the radial–brachial–subclavian axisare an important cause of procedural failure and there is varied dataon their prevalence.Objective: Aim of the present study was to investigate the incidenceof anomalies of radial–brachial–subclavian axis in patientsundergoing transradial coronary procedure and their impact onprocedural outcome.Methods: This was a single center study where a total of710 consecutive patients undergoing their first transradial coronaryprocedure were evaluated for the prevalence of anomaliesof radial–brachial–subclavian axis and their impact on proceduraloutcomes. This study took place from July 2016 to July 2017.Radial–ulnar–brachial axis was evaluated by retrograde radial arteriographyat the start of the procedure in each patient.Results: Out of the 710 patients enrolled in our study, 67% weremales with a mean age of 60 years (SD = 11). The incidence of radialartery anomalies was found out to be 10.9% (n = 78). The mostcommon radial anomaly was high-bifurcating radial origin (7.1%,n = 51). Extreme radial tortuosity was found in 17 patients (2.4%)full radial loop in 6 patients (0.8%) and other anomalies in 4 patients(0.5%). The overall procedure success rate was 97%, being morecommon in patients with normal radial–brachial–subclavian axis(0.7% vs 23%). Procedural failure was in highest in full radial loop(66%), followed by extreme radial tortuosity (23%) and then highradial bifurcation (17%). Vascular complications were also significantlymore in patients with abnormal radial–brachial–subclavianaxis.