Radial artery occlusion after transradial interventions: A systematic review and meta-analysis

Background-radial artery occlusion (rao) may occur posttransradial intervention and limits the radial artery as a future access site,thus precluding its use as an arterial conduit. in this study,we investigate the incidence and factors influencing the rao in the current literature. methods and results-we searched medline and embase for studies of rao in transradial access. relevant studies were identified and data were extracted. data were synthesized by meta-analysis,quantitative pooling,graphical representation,or by narrative synthesis. a total of 66 studies with 31 345 participants were included in the analysis. incident rao ranged between < 1% and 33% and varied with timing of assessment of radial artery patency (incidence of rao within 24 hours was 7.7%,which decreased to 5.5% at > 1 week follow-up). the most efficacious measure in reducing rao was higher dose of heparin,because lower doses of heparin were associated with increased rao (risk ratio 0.36,95% ci 0.17-0.76),whereas shorter compression times also reduced rao (risk ratio 0.28,95% ci 0.05-1.50). several factors were found to be associated with rao including age,sex,sheath size,and diameter of radial artery,but these factors were not consistent across all studies. conclusions-rao is a common complication of transradial access. maintenance of radial patency should be an integral part of all procedures undertaken through the radial approach. high-dose heparin along with shorter compression times and patent hemostasis is recommended in reducing rao. © 2016 the authors.