Kanovsky J - AIMRADIAL 2013 - OCT for radial injury
This study used optical coherence tomography (OCT) to assess radial artery injuries after percutaneous coronary intervention (PCI) in 40 patients. OCT imaging found only two minor injuries (5% of patients) and abnormal vessel wall structure in 5 patients (12.5%). This represents a major difference from a previous 2010 study that found a high number of intimal tears and medial dissections using time-domain OCT. The authors conclude that transradial access for coronary angiography and intervention carries a low risk of acute radial artery injuries, and that sheath length is an important factor affecting injury rates. Follow-up imaging will further examine any chronic changes in the radial artery.
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Kanovsky J - AIMRADIAL 2013 - OCT for radial injury
- 1. RADIAL ARTERY ACUTEINJURY AFTER PCI ASSESSED BY OPTICAL COHERENCE TOMOGRAPHY Kanovsky J., Poloczek M., Bocek O., Miklik R., Jerabek P., Ondrus T., Spinar J., Kala P. Department of Internal Medicine and Cardiology, University Hospital Brno, Brno, Czech Republic AimRADIAL2013, New York
- 2. Disclosure: Jan Kanovsky,MD, PhD Dr. Jan Kanovsky has no relevant financial interests to disclose AimRADIAL2013, New York
- 3. Background Importance of RAcondition The number of transradial coronary catheterizations and interventions is increasing The quality of the radial artery (RA) is crucial if used for the coronary artery bypass graft (CABG) The number of patients with more than one arterial conduit used for the CABG is increasing RA native disease is a predictor of coronary thin-cap fibroatheroma (TCFA)1 1 Di Vito, 2013 AimRADIAL2013, New York
- 4. Background OCT Optical coherence tomography(OCT) is intravascular imaging method with the highest resolution available (up to 10um) OCT of RA can provide detailed information about acute injury or chronic changes of the vessel after transradial catheterization1 1 Yonetsu, 2010 AimRADIAL2013, New York
- 5. TD-OCT study (Yonetsu,2009) High number of intimal tears and medial dissections Using 16cm sheath, for imaging pulled 14cm out Most of the injuries in the distal segment 1 Yonetsu, 2010 AimRADIAL2013, New York
- 6. Methods 40 consecutive patientsadmitted for coronary angiography (CAG) due to non-STEMI diagnosis First myocardial lesion in patients’s history First transradial CAG Informed consent Exclusion: STEMI, previous MI, acute heart failure, left main disease, renal insufficiency AimRADIAL2013, New York
- 7. Methods 6F 7cm sheath Pulledback of 3cm, guiding catheter moved back into the sheath FD-OCT recording of RA, starting 8cm from the sheath tip (using X-ray contrast ruler) Manual injection of the 100% contrast fluid AimRADIAL2013, New York
- 8. Results Only twominor injuries found (5%) Few patients with abnormal vessel wall structure (5pts, 12,5%, intimal thickening, calcifications, qualitative assessment) No thrombotic mass found All patient asymptomatic AimRADIAL2013, New York
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- 11. Discussion In most ofthe patients (95%), we found no acute injury and normal vessel structure Major difference in results comparing to the Yonetsu study from 2010 Two main differences – sheath length, TD vs FD OCT imaging AimRADIAL2013, New York
- 12. Conclusion Transradial CAGand intervention is a safe access route, with minor incidence of acute injuries The length of sheath is likely important for the incidence of RA injury Chronic changes are the subject of further research in the project (all patients scheduled for 9 months follow-up CAG and OCT). AimRADIAL2013, New York
- 13. Thank you foryour attention. Supported by the Grant of the IGA Ministry of Health of the Czech Republic no. NT/13830. AimRADIAL2013, New York