Učestalost anatomskih varijacija radijalne arterije zamijećenih pri transradijalnoj kateterizaciji srca

master's thesis

• Title (english): The prevalence of anatomic variations of the radial artery observed during transradial heart catheterization
• Author: Zvonimir Ostojić
• Mentor: Joško Bulum (mentor)
• Committee member: Aleksandar Ernst (predsjednik povjerenstva)
• Committee member: Dubravko Jalšovec (član povjerenstva)
• Committee member: Joško Bulum (član povjerenstva)
• Granter: University of Zagreb; School of Medicine; (Department of Internal Medicine); Zagreb
• Defense date and country: 2014-07-15, Croatia
• Scientific / art field, discipline and subdiscipline: BIOMEDICINE AND HEALTHCARE; Clinical Medical Sciences; Internal Medicine

Abstract

Posljednjih desetak godina kateterizacija srca transradijalnim pristupom sve se više koristi prvenstveno zbog rjeđih i lakših mogućih komplikacija u usporedbi s femoralnim pristupom. Ipak, jedan od većih nedostataka transradijalnog pristupa je relativno visoka učestalost neuspjele kateterizacije (od 1 do 5%). Na drugom mjestu uzroka iste, nalaze se anatomske varijacije radijalne arterije. Dosadašnji radovi nisu dali jednoznačne podatke o učestalosti ovih anomalija, stoga je cilj ovog istraživanja odrediti učestalost anatomskih varijacija pomoću rutinskih angiografija radijalne arterije (RA) prilikom PTCA/PCI. Radi se o retrospektivnoj studiji u kojoj su pregledane 602 snimke rutinskih angiografija radijalne arterije učinjene prilikom kateterizacije srca. Učestalost anatomskih varijacija RA iznosila je 8,8%, ne uključujući tortuozitete čija učestalost iznosi 12,7%. Najčešća anatomska varijacija je bila visoko polazište radijalne arterije u ukupnom broju od 31 (5,1%) ispitanika. Radio-ulnarne petlje, kao jedna od potencijalnih kontraindikacija za zahvat, pojavile su se u 2% slučajeva. Regresijskom analizom utvrđeno je da godine starosti (p<0,001), ženski spol (p=0,015) i visoko polazište radijalne arterije (p=0,034) statistički značajno doprinose razvoju tortuoziteta. Rezultati ukazuju da se učestalost tortuoziteta s godinama linearno povećava. Iako isti nisu kontraindikacija za nastavak zahvata, preporuča se da se kod starijih pacijenata, zbog njihove veće učestalosti, na početku zahvata učini angiografija s ciljem izbjegavanja potencijalnih komplikacija zahvata.

Abstract (english)

Over the last ten years, transradial cardiac catheterization has been increasingly applied, primarily because of its lower incidence of complications compared to the femoral approach. However, one of the greatest flaws of the transradial approach is a relatively high incidence of catheterization failure (1-5%). Anatomic variations of the radial artery are ranked second among the reasons for this. Previous studies have not provided unambiguous data on the frequency of these anomalies. It is therefore the aim of this study to determine the frequency of anatomic variations using routine angiographies of the radial artery (RA) during left heart catheterization. This is a retrospective study involving the examination of 602 images of routine angiographies of the radial artery performed during cardiac catheterization. The frequency of anatomic variations of RA was 8.8%, exclusive of tortuosities whose frequency was 12.7%. The most frequent anatomic variation was the high origin of the radial artery, found in a total of 31 (5.1%) subjects. Radioulnar loops, being one of potential contraindications for the procedure, were reported in 2% of the cases. Regression analysis revealed that the age (p<0.001), female sex (p=0.015) and high origin (p=0.034) statistically significant contributed to the development of tortuosity. The results indicate that the incidence of tortuosity increases linearly with age. Although this is not a contraindication for continuing with the procedure, we recommend that elderly patients have angiography performed at the beginning of the procedure due to the higher frequency of tortuosity.

• Keywords: radijalna arterija; kateterizacija srca/klasifikacija; kateterizacija srca/komplikacije; radijalna arterija/abnormalnosti; perkutana koronarna intervencija
• Keywords (english): radial artery; cardiac catheterisation/classification; cardiac catheterisation/complications; radial artery/abnormalities; percutaneous coronary intervention
• Language: croatian
• URN:NBN: urn:nbn:hr:105:562712
• Study programme: Title: Medicine; Study programme type: university; Study level: integrated undergraduate and graduate; Academic / professional title: doktor/doktorica medicine (doktor/doktorica medicine)
• Type of resource: Text
• File origin: Born digital
• Access conditions: Open access
• Created on: 2015-10-12 14:45:12