The transradial approach has recently gained popularity in invasive cardiology. Collateral circulation through the ulnar (UA) and anterior interosseous artery (AIA) compensates for radial artery (RA) occlusion (RAO). We evaluated arterial circulation in the forearm and hand in patients with RAO after coronary angiography (CA) and percutaneous coronary interventions (PCIs).
Methods:
This prospective observational study included 40 RAO patients (mean age, 71.22 ± 9.99 years) after CA/PCI. Collateral circulation was assessed using ultrasonography and the Barbeau test. Doppler ultrasound and anatomical parameters of RAO were evaluated.
Results:
The RA, UA, and AIA differed in peak systolic velocity, end-diastolic velocity, arterial diameter, total flow volume, and stroke volume (p < 0.01). Pulse quality differed between the RA and UA (p < 0.0001). Blood flow direction in the distal RA divided patients into those with antegrade flow from the AIA and retrograde flow from the UA (50% each). In logistic regression, Barbeau test results for fingers 2 (p = 0.0006, OR = 0.1398) and 4 (p = 0.004, OR = 0.2843) predicted the direction of blood flow in the distal RA.
Conclusion:
Ultrasound and functional evaluation can be used to assess collateral circulation and predict blood flow direction in RAO patients. However, further research is needed to confirm these findings.
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