Radial artery patency outcomes with saline flushing of the radial sheath after coronary intervention: A prospective cohort study.

Publisher: Sage Publications Country of Publication: United States NLM ID: 100940729 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1724-6032 (Electronic) Linking ISSN: 11297298 NLM ISO Abbreviation: J Vasc Access Subsets: MEDLINE

Publication: 2018- : Thousand Oaks, CA : Sage Publications
Original Publication: Milano ; Birmingham : Wichtig, c2000-

Radial Artery*/physiopathology ; Radial Artery*/diagnostic imaging ; Vascular Patency* ; Saline Solution*/administration & dosage ; Saline Solution*/adverse effects ; Catheterization, Peripheral*/adverse effects ; Punctures* ; Ultrasonography, Doppler*; Humans ; Prospective Studies ; Male ; Female ; Aged ; Middle Aged ; Treatment Outcome ; Time Factors ; Risk Factors ; Arterial Occlusive Diseases/physiopathology ; Arterial Occlusive Diseases/etiology ; Arterial Occlusive Diseases/diagnostic imaging ; Arterial Occlusive Diseases/prevention & control ; Percutaneous Coronary Intervention/adverse effects ; Percutaneous Coronary Intervention/instrumentation ; Vascular Access Devices ; Therapeutic Irrigation/adverse effects

Objective: The implications of saline flushing of the radial sheath have not been studied in terms of radial artery occlusion. We aimed to investigate radial artery patency outcomes after the saline flush of the radial sheath.
Methods: In this prospective observational study, patients were selected to receive either radial sheath flushing with 10 mL of saline after pulling the sheath to one-third of its length (Group 1) or standard care (Group 2) after removal of the catheter sheath as per physician discretion. Radial artery patency was assessed by Doppler ultrasound at 24 h and 30 days after the procedure.
Results: A total of 2877 patients were enrolled in the study, with 1340 receiving radial sheath flushing and 1537 receiving standard care. At 24 h after the procedure, the incidence of radial artery occlusion was significantly lower in the radial sheath flushing group compared to the standard care group (4.4% vs 12.6%, p  = 0.027). This difference persisted 30 days after the procedure (6.1% vs 15.8%, p  = 0.015). Radial sheath flushing was independently associated with a lower risk of radial artery occlusion 30 days after the procedure, after adjusting for potential confounders (OR 0.375, 95% CI 0.18-0.77, p  = 0.008).
Conclusion: In conclusion, this prospective study provides evidence to support the use of radial sheath flushing after coronary intervention via the radial artery as a simple and effective strategy for reducing the risk of radial artery occlusion without increasing the risk of other adverse outcomes.
Competing Interests: Declaration of conflicting interestsThe authors declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Keywords: Arterial access; distal radial artery; ischemic heart disease; radial sheath; vascular access

0 (Saline Solution)

Date Created: 20231011 Date Completed: 20241106 Latest Revision: 20241106

20241106

10.1177/11297298231202538

37817644