Radial artery occlusion
( RAO ) is One of the most important and underdiagnosed complications of radial artery access , which is closely related to degree of Anticoagulation
6. RAO Presentation
1. Rare ( Incidence is Variable from 1.1% to 20% )
2. Usually Asymptomatic ( Clinically Silent )
( Asymptomatic Loss of Radial Pulse due to the Extensive Collateral Circulation
from the Ulnar and Interosseous Arteries )
3. Often Reversible ( 40% to 60% of Cases, the Pulse Could be Redetected
within Hours to weeks after the Occlusion , majority will Spontaneously
Recanalize within a month )
7. Presence of a Radial Artery Pulse Does Not Rule
Out RAO as a Result of the Presence of Collateral
Circulation Through the Palmar Arches
RAO and Radial Pulse
9. RAO Outcomes
RAO , Even if Asymptomatic, Can :
1. Limit future Radial Access
2. Limit the Use of the Radial Artery for Dialysis Fistula
3. As a Conduit for Bypass Grafts
4. Invasive Arterial Pressure Monitoring
Though RAO Should be Prevented when Possible
25. Treatment for Asymptomatic patients is Observation Alone
If RAO is noted early after the Procedure (3-4 hours after removal of the TR band),
1. Ipsilateral Ulnar Artery Compression for 1 h to Promote RA Reopening has Been
shown to be Successful
2. Treatment with Anticoagulation ( Enoxaparin or Fondaparinux or NOAC )
for 4 weeks increases the rate of recanalization
RAO Treatment
( Symptomatic vs Asymptomatic )