FREQUENCY OF LOSS OF RADIAL PULSE IN PATIENTS UNDERGOING TRANSRADIAL CORONARY CATHETERIZATION

Abstract

Background: The transradial approach (TRA) has emerged as the preferred access route for coronary catheterization, offering reduced bleeding complications, earlier ambulation, and improved patient comfort compared to transfemoral access. Despite these benefits, radial artery occlusion (RAO)—often manifesting as loss of radial pulse—remains the most frequent complication of TRA. Although frequently asymptomatic due to dual hand blood supply, RAO can compromise future use of the radial artery for coronary interventions, dialysis access, or bypass grafting. Identifying its frequency and associated risk factors is crucial for prevention and long-term vascular preservation.

Objective: To determine the frequency of loss of radial pulse and its associated risk factors in patients undergoing transradial coronary catheterization.

Methods: This descriptive study was conducted over six months at the Department of Cardiology, Lady Reading Hospital, Peshawar. A total of 113 patients with coronary artery disease, aged 25–70 years, who met predefined inclusion criteria, underwent transradial coronary catheterization. Post-procedural loss of radial pulse was assessed at 24 hours using the Reverse Barbeau Test and confirmed via Doppler ultrasound. Data were analyzed using SPSS version 26. Categorical variables were reported as frequencies and percentages, continuous variables as mean ± standard deviation, and associations tested using Chi-square or Fisher’s exact test, with p ≤ 0.05 considered statistically significant.

Results: The mean age was 56.3 ± 8.9 years; 68 patients (60.2%) were male and 45 (39.8%) female. Hypertension was present in 62 patients (54.9%), diabetes mellitus in 48 (42.5%), and previous radial cannulation in 17 (15.0%). Loss of radial pulse occurred in 13 patients (11.5%). Significant associations were found with diabetes mellitus (61.5%, p = 0.044), BMI > 27 kg/m² (76.9%, p = 0.038), and previous radial cannulation (38.5%, p = 0.031). Gender, age, and hypertension were not significantly associated.

Conclusion: Loss of radial pulse after TRA was consistent with global trends, with metabolic factors and prior radial access as significant predictors. Pre-procedural risk stratification, patent hemostasis, and routine post-procedure patency checks are essential to reduce RAO risk and preserve future vascular access.