Elsevier

The Annals of Thoracic Surgery

Volume 82, Issue 5, November 2006, Pages 1698-1702
The Annals of Thoracic Surgery

Original article
Cardiovascular
Radial Artery Diameter and Vasodilatory Properties After Transradial Coronary Angiography

https://doi.org/10.1016/j.athoracsur.2006.06.017Get rights and content

Background

The radial artery is proposed as an alternative conduit in coronary revascularization. During the last years the transradial approach has, in many centers, emerged as the preferred technique in percutaneous diagnostic and interventional coronary procedures. This induces a trauma to the radial artery that possibly could influence its suitability as a bypass graft. In this study we assessed by ultrasound the long-term effects of transradial coronary angiography on the radial artery diameter and vasodilatory properties.

Methods

Thirty patients were examined with high resolution ultrasound 10 to 14 months after a transradial coronary angiography. Radial artery baseline diameter and response to flow-mediated (FMD) and nitroglycerin-mediated vasodilation (NMD) were examined in the right radial artery with the unexposed left radial artery as control.

Results

Right radial artery diameter was reduced compared with the left radial artery (2.58 ± 0.38 vs 2.71 ± 0.32 mm, p < 0.01). Both FMD and NMD were preserved in the exposed artery (FMD 8.4 ± 8.0 vs 8.0 ± 6.1%, NMD 15.5 ± 6.8 vs 16.7 ± 6.6%, both ns). Due to the reduced baseline diameter, the right radial lumen diameter remained significantly smaller after vasodilatory stimuli. Large interindividual differences were demonstrated.

Conclusions

The radial artery diameter is diminished one year after transradial coronary angiography while vasodilatory properties are preserved. The preserved vasodilatory capacity could favorably influence the suitability of the artery as bypass graft. However, with the long-term structural changes induced by transradial angiography, use of a catheter-exposed radial artery as a conduit in coronary artery revascularization should not be strongly recommended. With ultrasound, both structure and vasodilatory properties of a catheterization-exposed radial artery may be assessed in case the artery is considered as bypass material.

Section snippets

Patients and Methods

This study was approved by the Regional committee for medical ethics and all patients gave their written informed consent (REK 076-04, approved May 5, 2004).

Results

The right RA was occluded in one patient (3.3%) without giving any symptoms. This patient was excluded, thus leaving 29 patients for further analysis. Table 3 shows mean baseline diameters and diameters after FMD and NMD in right and left RAs. Baseline diameter was significantly smaller in the right compared with the left RA. In both arteries significant responses to FMD and NMD were obtained (Table 4). When expressed as the absolute diameter change in millimeters, the dilation was slightly

Comment

In this study we have demonstrated a significant decrease in RA diameter one year after transradial angiography, while the responses to FMD and NMD did not significantly differ between the catheterization exposed right and the unexposed left RA. Thus, both endothelial dependent and endothelial independent vasodilatory properties were preserved. Due to the reduced baseline diameter, there was a significantly reduced diameter after vasodilatory stimuli in the right compared with the left RA.

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  • Ultrasound evaluation of the radial artery in young adults — A pilot study

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    Moreover, in some studies, nitroglycerin was used for initial widening of the artery, or the analysis was conducted in patients who had already been subjected to procedures that interrupted the continuity of radial artery. Procedures of this kind may also influence the obtained results (Chandrasekhar and Mehran, 2015; Chen et al., 2018; Madssen et al., 2006). The reported small vessel diameter, although tested on a population of healthy young individuals, may be of some importance when performing arterial punctures in young or asthenic older people.

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