FREQUENCY OF LOSS OF RADIAL PULSE IN PATIENT UNDERGOING CORONARY ANGIOGRAPHY

Abstract

Background: Coronary angiography via the transradial approach is widely preferred due to its lower risk of bleeding and improved patient comfort. However, vascular complications such as radial artery occlusion and transient or permanent loss of radial pulse remain concerns. These complications can compromise future vascular access and impact procedural success. Understanding the frequency, risk factors, and recovery patterns of radial pulse loss post-procedure is essential for optimizing patient management and refining procedural protocols to enhance safety and long-term arterial patency.

Objective: This study aimed to determine the frequency of radial pulse loss following coronary angiography, assess its temporal recovery, and evaluate associated patient and procedural factors.

Methods: A prospective descriptive cross-sectional study was conducted at the National Institute of Cardiovascular Diseases (NICVD), Karachi. A total of 890 patients aged 18 to 70 years undergoing primary percutaneous coronary intervention (PCI) via the radial approach were enrolled. Patients with non-ST elevation myocardial infarction (NSTEMI), prior radial access, or peripheral arterial disease were excluded. Radial pulse was assessed at multiple time points using palpation and Doppler ultrasound. Data were analyzed using SPSS Version 21.0, with statistical tests applied to evaluate associations between patient characteristics, procedural variables, and pulse loss incidence.

Results: The mean patient age was 54.79 ± 9.14 years, with 70.22% being male. Hypertension (59.78%), diabetes mellitus (31.35%), and smoking history (34.27%) were common comorbidities. Immediately post-procedure, radial pulse loss occurred in 9.21% of patients. By 12 hours, pulse was restored in 89.10%, increasing to 93.93% at 24 hours, 848 (95.28%) at discharge and 97.64% at follow-up. Doppler flow confirmed recovery in 92.81% at baseline, 91.80% at 12 hours, 96.07% at 24 hours, 849 (95.39%) at discharge and 97.75% at follow-up.

Conclusion: Radial pulse loss following coronary angiography was initially observed in a significant proportion of patients but showed substantial recovery over time. Early identification, standardized hemostasis protocols, and improved monitoring strategies are crucial to minimizing vascular complications and ensuring long-term arterial patency.