Incidence and Determinants of Early Radial Artery Occlusion Following Transradial Coronary Angiography and Intervention: A Prospective Observational Study

Abstract

Objectives: To determine the 24-hour incidence of Doppler-confirmed radial artery occlusion and identify clinical and procedural predictors of RAO in patients undergoing transradial coronary procedures. Methodology: This prospective observational study enrolled 196 adult patients undergoing TRA coronary angiography or PCI at a tertiary cardiac center from March to September 2024. Clinical, laboratory, and procedural data were documented. RAO was assessed 24 hours post-procedure using color Doppler ultrasonography. Univariate and multivariable logistic regression analyses were performed to identify independent predictors of RAO. Results: Among 196 patients (mean age 59.6 ± 11.7 years; 65.3% male), the 24-hour incidence of RAO was 11.2% (n = 22). Patients with RAO had significantly higher HbA1c levels (p = 0.002), higher rates of multiple puncture attempts (p < 0.001), complex PCI (p < 0.001), and higher-grade hematomas (p < 0.001). On multivariable analysis, prolonged hemostasis duration emerged as the only independent predictor of RAO (adjusted OR 1.13, 95% CI 1.06–1.20; p < 0.001). Conclusion: Prolonged hemostasis duration is a strong independent determinant of early RAO following transradial coronary procedures. Optimization of patent hemostasis techniques and minimizing compression time may significantly reduce RAO and preserve long-term radial artery patency.