Limitations of successive transradial approach in the same arm: The Japanese experience

The transradial approach (TRA) has been used for diagnostic and interventio nal cardiology. It has not previously been determined how many times the sa me radial artery can be cannulated without complications. A total of 812 pa tients (502 men and 310 women) underwent angiography or angioplasty via the TRA between 1997 and 1999 at our institution with a total of 1,438 procedu res. Sheaths were 5 (55%) or 6 Fr (45%). Dropout rates of 3.5% and 7.9% wer e found at the second TRA attempt in the men and the women, respectively. O f the 62 TRA failures, 56 (90%) were due to narrowing or occlusion of the r adial artery after the previous TRA procedure. A third TRA procedure was po ssible in 90% of the men and 80% of the women. A fifth TRA procedure was po ssible in 70% of the men and 50% of the women. The dropout rates for TRA in creased as successive punctures were performed. This was primarily due to v essel narrowing and occlusion occurring as a function of multiple punctures . (C) 2001 Wiley-Liss, Inc.