Radial artery remodeling after primary PCI assessed by OCT

1. S
RADIAL ARTERY REMODELING
AFTER PRIMARY PCI ASSESSED BY
OCT
Kanovsky J, Novakova T, Miklik R, Ondrus T, Poloczek M, Bocek O, Spinar J, Kala P
Department of Internal Medicine and Cardiology, University Hospital Brno
Brno, Czech Republic
AimRADIAL2014, Chicago

2. Disclosure: Jan Kanovsky, MD, PhD
S Dr. Jan Kanovsky has no relevant financial interests to disclose
AimRADIAL2014, Chicago

3. Background
Radial artery
S Transradial approach in percutaneous coronary
interventions is preferred in many cathlabs for its safety
and comfort for the patient.
S Number of transradial catheterizations is increasing
worldwide comparing to transfemoral approach. Clinically
significant complications in radial artery itself are
extremely rare.
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4. Background
OCT
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S Optical coherence
tomography (OCT) is the
most sensitive method
available for the evaluation
of the vessel wall layers on
close to microscopic level
in vivo.

5. Methods I.
S 30 consecutive patients admitted for coronary angiography
(CAG) due to non-STEMI diagnosis
S First myocardial lesion in patients’s history
S First transradial CAG
S Informed consent
Exclusion: STEMI, previous MI, acute heart failure, left main
disease, renal insufficiency
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6. Methods II.
S 6F 7cm sheath
S At the end of PCI sheath pulled back
of 3cm, guiding catheter moved
back into the sheath
S FD-OCT 53mm recording of RA,
starting 8cm from the sheath tip
(using X-ray contrast ruler)
S Manual injection of the 100%
contrast fluid, routine nitrate
administration during the procedure
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7. Methods III.
S 9 months follow-up
S Same SOP compared to
baseline
S Manual analysis of intimal
layer thickness and lumen area
both in baseline and follow-up
S Cross section thickness
analysis each 3mm (360°)
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8. Radial Artery Imaging
Baseline Follow-up
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9. Remodeling
Baseline Follow-up
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10. Results
Intimal thickness
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11. Results
Mean lumen area
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14.00
12.00
10.00
8.00
6.00
4.00
2.00
0.00
Baseline Follow-up
Mean lumen area

12. Results
Baseline Follow-up p
Intimal thickness 0,066±0,012mm 0,082±0,014mm 0,0023
Mean lumen
7,120±1,830mm 6,300± 1,780mm 0,18
area
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13. Conclusion
S The transradial PCI
changes the structure
of the RA, even after
only one procedure
S The intimal layer was
significantly thickened
9 months after the first
catheterization
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14. Conclusion
S There was no significant effect on vessel lumen area
S More than 100 patients included in the project to confirm
data
S Should we aim to contralateral radial artery for graft
harvesting?
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15. Thank you for your attention.
S Supported by the Grant of the IGA Ministry of Health of the Czech
Republic no. NT/13830.
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