Interruption of blood flow during compression and radial artery occlusion after transradial catheterization

Abstract

Objectives: To analyze the possible relationship between compression after transradial catheterization and radial artery occlusion.

Background: Radial artery occlusion is an important concern of transradial catheterization. Interruption of radial artery flow during compression might influence the rate of radial artery occlusion at follow-up.

Methods: A prospective study including 275 consecutive patients undergoing transradial catheterization was conducted. Arterial sheaths were removed immediately after procedures and conventional compressive dressings were left in place for 2 hr. The pulse oximeter signal in the index finger during ipsilateral ulnar compression was used for the assessment of radial artery flow.

Results: Radial artery flow was absent in 174 cases (62%) immediately after entry-site compression. After 2 hr of conventional hemostasis, radial artery flow was absent in 162 cases (58%) before bandage removal. At 7-day follow-up, 12 patients (4.4%) had absent pulsations and radial artery flow was absent in 29 cases (10.5%). Patients with an occluded radial artery at follow-up had significantly smaller arterial diameters at baseline (2.23+/-0.4 mm vs. 2.40+/-0.5 mm; P=0.032) and more frequently had absent flow during hemostasis (90% vs. 54%, P<0.001). Stepwise logistic regression analysis revealed that absent flow before compressive bandages removal was the only independent predictor of radial artery occlusion at follow-up (OR=6.7; IC 95%: 1.95-22.9; P=0.002).

Conclusions: Flow-limiting compression is a frequent finding during conventional hemostasis after transradial catheterization. Absence of radial artery flow during compression represents a strong predictor of radial artery occlusion.