TY - JOUR
T1 - Chronic radial artery occlusion does not cause exercise induced hand ischemia
AU - van der Heijden, Dirk J.
AU - van Leeuwen, Maarten A.H.
AU - Ritt, Marco J.P.F.
AU - van de Ven, Peter M.
AU - van Royen, Niels
PY - 2018/12/1
Y1 - 2018/12/1
N2 - Objectives: The aim of the study was to evaluate the occurrence of hand ischemia in patients with radial artery occlusion (RAO), using the contralateral hand as control. Background: Radial artery occlusion is a common complication (6%) after transradial access (TRA) but rarely leads to major ischemic events due to the collateral perfusion of the hand. However, it has been reported that RAO can become symptomatic, possibly as a consequence of hand ischemia. To evaluate the existence of exercise induced hand ischemia in patients with RAO, we initiated the present study. Methods: After a transradial coronary procedure, patients with suspicion of RAO were asked for study participation. After informed consent, radial ultrasound was performed. In patients with confirmed RAO, rest perfusion of the digits was analyzed by laser Doppler digital imaging. Occurrence of ischemia during exercise was assessed with transcutaneous oxygen pressure (TcPO2) and thumb capillary lactate. All analyses were performed in both the RAO side as well as the contralateral side as control. Results: RAO occlusion was confirmed in 18 patients. After 5 min of exercise there were no significant differences in TcPO2 (51.4 mmHg [±17.2] vs 43.9 mmHg [±15.5], P = 0.18) or lactate (2.0 mmol/L [±0.7] vs 2.1 mmol/L [±0.7], P = 0.80) between RAO side and control side. Differences in mean TcPO2 were found to be stable during exercise and not different from baseline differences. Conclusions: Chronic radial artery occlusion does not lead to exercise induced hand ischemia.
AB - Objectives: The aim of the study was to evaluate the occurrence of hand ischemia in patients with radial artery occlusion (RAO), using the contralateral hand as control. Background: Radial artery occlusion is a common complication (6%) after transradial access (TRA) but rarely leads to major ischemic events due to the collateral perfusion of the hand. However, it has been reported that RAO can become symptomatic, possibly as a consequence of hand ischemia. To evaluate the existence of exercise induced hand ischemia in patients with RAO, we initiated the present study. Methods: After a transradial coronary procedure, patients with suspicion of RAO were asked for study participation. After informed consent, radial ultrasound was performed. In patients with confirmed RAO, rest perfusion of the digits was analyzed by laser Doppler digital imaging. Occurrence of ischemia during exercise was assessed with transcutaneous oxygen pressure (TcPO2) and thumb capillary lactate. All analyses were performed in both the RAO side as well as the contralateral side as control. Results: RAO occlusion was confirmed in 18 patients. After 5 min of exercise there were no significant differences in TcPO2 (51.4 mmHg [±17.2] vs 43.9 mmHg [±15.5], P = 0.18) or lactate (2.0 mmol/L [±0.7] vs 2.1 mmol/L [±0.7], P = 0.80) between RAO side and control side. Differences in mean TcPO2 were found to be stable during exercise and not different from baseline differences. Conclusions: Chronic radial artery occlusion does not lead to exercise induced hand ischemia.
KW - hand ischemia
KW - lactate
KW - radial artery occlusion
KW - transcutaneous oxygen pressure
KW - transradial access
UR - http://www.scopus.com/inward/record.url?scp=85052801138&partnerID=8YFLogxK
U2 - https://doi.org/10.1111/joic.12552
DO - https://doi.org/10.1111/joic.12552
M3 - Article
C2 - 30168201
SN - 0896-4327
VL - 31
SP - 949
EP - 956
JO - Journal of Interventional Cardiology
JF - Journal of Interventional Cardiology
IS - 6
ER -