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Upper limb function unaffected by transradial procedures
Coronary revascularizations and interventions performed via the radial artery do not appear to have an effect on self-reported upper limb function.
Researchers analyzed changes in upper limb function in 338 patients who underwent coronary catheterization from January 2013 to February 2014 (mean age, 64 years; 72% men). The transradial approach was used in 85% of the patients and the transfemoral approach in 15% of patients.
The primary endpoint was change in upper extremity function from baseline to 30 days using a shortened version of the disabilities of the arm, shoulder and hand questionnaire (QuickDASH). At baseline, the mean QuickDASH score was not different for patients who underwent transradial or transfemoral procedures, but was significantly higher in women and elderly patients aged at least 75 years. The researchers reported no significant change from baseline to 30 days for upper limb function in patients who underwent transradial procedures (P = .06). The QuickDASH score in this group was 4.55 at baseline and 2.27 at 30-day follow-up. A similar trend was observed in the femoral group: QuickDASH baseline score, 6.82; QuickDASH 30-day score, 5.68.
“Although a proportion of patients reported deterioration of upper limb function after transradial access, this was not numerically or statistically different from patients with a transfemoral access,” the researchers wrote.
Procedure-related extremity complaints through 30 days were reported in 10.5% of the transradial group vs. 11.5% of the transfemoral group (P = .82). The most common complains in both groups were pain (43%), tingling (10%), less power (7%), stiffness (7%) and numbness (7%).
Cold intolerance symptom severity (CISS) questionnaire scores did not change significantly from baseline to 30 days with transradial access (P = .91) or femoral access (P = .96). In addition, the development of pathological cold intolerance was not associated with access route.
“Despite the anatomic and physiologic changes that are induced by radial access, our study demonstrated that patients do not report a significant reduction of upper extremity function after transradial catheterization,” the researchers concluded. – by Rob Volansky
Disclosure: The researchers report no relevant financial disclosures.