This document discusses radial artery occlusion (RAO) following cardiac catheterization. It summarizes data from studies showing a low rate of RAO ranging from 0-13% depending on the device used. Of over 25,000 procedures involving the radial artery over 8 years, only 1200 cases of RAO were observed, with no cases of hand ischemia. While RAO is common, clinical hand ischemia following RAO appears to be very rare. The low risk of hand ischemia does not outweigh the benefits of radial artery access for cardiac procedures.

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Radial Artery
Occlusion
Does it clinically matter

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Various commercial devices
TR BandHome made (R)
2

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Definitions
 DP: Doppler ultrasound proven RAO
 CP: Clincally proven
 No Allen´s test performed
4

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3,8% 3,6%
0%
5%
10%
15%
20%
25%
30%
35%
In 8 yrs = 25 000 procedures /14,000TRA
1,200 RAO
NO Hand Ischemia observed!
DP CP

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Pancholy SB et al., 2009

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DRABAND registry
2,2%
2,0%
1,0%
2,2%
0,0%
0,4%
13,0%
0,0%
3,8%
0% 5% 10% 15%
A (93)
B (98)
C (111)
D (35)
E (45)
F (44)
G (13)
H (135)
Mean
with courtesy J.Mosegu, modified

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Does Hand Ischemia even
exists post RAO if dual
blood flow is evident?

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Conclusion
 Although radial artery thrombosis is a
common sequela of radial artery
cannulation, clinical hand ischemia is
very rare
 The low risk of hand ischemia does
not counterbalance the benefit of
radial access

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Conclusion
 Assessment of the hand circulation, such as Allen’s test, is often normal in
patients who develop ischemia after radial artery cannulation; conversely,
cannulation appears to be safe in patients with abnormal Allen tests. [3],
[4] and [7] Other causes for ischemia have been suggested, but no single
cause can explain the development of ischemia in the majority of reported
cases. Therapeutic options have been largely speculative, and results have
been anecdotal with limited followup. Hand ischemia is a rare but
potentially devastating complication of radial artery cannulation.

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Conclusion