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Biochemical and clinical evaluation of endothelial injury after distal or traditional transradial access in percutaneous interventions

Karol Momot1, Maciej Zarębiński2, Krzysztof Flis2, Katarzyna Czarzasta1, Liana Puchalska1, Małgorzata Wojciechowska1
DOI: 10.33963/KP.a2022.0108
·
Pubmed: 35445740
Affiliations
  1. Laboratory of Center for Preclinical Research, Department of Experimental and Clinical Physiology, Medical University of Warsaw, Warszawa, Poland
  2. Department of Invasive Cardiology, Lazarski University, Independent Public Specialist Western Hospital John Paul II, Grodzisk Mazowiecki, Poland

open access

Online first
Original article
Published online: 2022-04-21

Abstract

BACKGROUND: Distal transradial access (dTRA) has been proposed as an alternative to traditional transradial access (TRA) in cardiac catheterization.

AIMS: The aim of the study was to compare these two transradial approaches: TRA and dTRA in terms of clinical and biochemical aspects.

METHODS: Two hundred patients qualified for elective coronary procedure were included. The patients were assigned to one of the groups depending on the vascular access. The groups were compared in terms of perceived pain using Visual Analogue Scale (VAS), time of gaining the access, need for conversion and local complications. Additionally, in forty patients circulating endothelial injury markers: Endothelin-1 (ET-1), Interleukin-8 (IL-8) and Soluble Vascular Cell Adhesion Molecule-1 (sVCAM-1) were assessed.

RESULTS: Successful cannulation was obtained in 84 (100%) in the TRA group and in 98 (84%) subjects in the dTRA (P <0.001). dTRA was associated with higher level of pain perceived at the time of gaining vascular approach than TRA; median VAS score (IQR): 4 (2-5) vs. 2 (2-4) (P = 0.04). The mean time (standard deviation [SD]) needed to cannulate the artery in dTRA was longer than in TRA: 81 (8) seconds vs. 50 (4) seconds (P=0.04). ET-1 concentration was (SD): 2.08 (0.19) [dTRA] vs. 2.00 (0.29) [TRA] pg/ml (P = 0.83); sVCAM-1: 12.71 (3.97) vs. 12.86 (4.29) ng/ml (P = 0.98); IL-8: 8.81 (0.42) vs. 9.15 (0.52) ng/ml (P = 0.62). Number of complications after procedures did not differ between these two approaches.

CONCLUSIONS: Cannulation of dTRA is associated with lower success rate and higher pain perceived. dTRA is not inferior to TRA when safety issues and vascular injury are considered.

Abstract

BACKGROUND: Distal transradial access (dTRA) has been proposed as an alternative to traditional transradial access (TRA) in cardiac catheterization.

AIMS: The aim of the study was to compare these two transradial approaches: TRA and dTRA in terms of clinical and biochemical aspects.

METHODS: Two hundred patients qualified for elective coronary procedure were included. The patients were assigned to one of the groups depending on the vascular access. The groups were compared in terms of perceived pain using Visual Analogue Scale (VAS), time of gaining the access, need for conversion and local complications. Additionally, in forty patients circulating endothelial injury markers: Endothelin-1 (ET-1), Interleukin-8 (IL-8) and Soluble Vascular Cell Adhesion Molecule-1 (sVCAM-1) were assessed.

RESULTS: Successful cannulation was obtained in 84 (100%) in the TRA group and in 98 (84%) subjects in the dTRA (P <0.001). dTRA was associated with higher level of pain perceived at the time of gaining vascular approach than TRA; median VAS score (IQR): 4 (2-5) vs. 2 (2-4) (P = 0.04). The mean time (standard deviation [SD]) needed to cannulate the artery in dTRA was longer than in TRA: 81 (8) seconds vs. 50 (4) seconds (P=0.04). ET-1 concentration was (SD): 2.08 (0.19) [dTRA] vs. 2.00 (0.29) [TRA] pg/ml (P = 0.83); sVCAM-1: 12.71 (3.97) vs. 12.86 (4.29) ng/ml (P = 0.98); IL-8: 8.81 (0.42) vs. 9.15 (0.52) ng/ml (P = 0.62). Number of complications after procedures did not differ between these two approaches.

CONCLUSIONS: Cannulation of dTRA is associated with lower success rate and higher pain perceived. dTRA is not inferior to TRA when safety issues and vascular injury are considered.

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Keywords

percutaneous interventions, coronarography, radial access

About this article
Title

Biochemical and clinical evaluation of endothelial injury after distal or traditional transradial access in percutaneous interventions

Journal

Kardiologia Polska (Polish Heart Journal)

Issue

Online first

Article type

Original article

Published online

2022-04-21

Page views

107

Article views/downloads

81

DOI

10.33963/KP.a2022.0108

Pubmed

35445740

Keywords

percutaneous interventions
coronarography
radial access

Authors

Karol Momot
Maciej Zarębiński
Krzysztof Flis
Katarzyna Czarzasta
Liana Puchalska
Małgorzata Wojciechowska

References (26)
  1. Sgueglia GA, Di Giorgio A, Gaspardone A, et al. Anatomic basis and physiological rationale of distal radial artery access for percutaneous coronary and endovascular procedures. JACC Cardiovasc Interv. 2018; 11(20): 2113–2119.
  2. Koutouzis M, Kontopodis E, Tassopoulos A, et al. Distal versus traditional radial approach for coronary angiography. Cardiovasc Revasc Med. 2019; 20(8): 678–680.
  3. Kjaergaard AG, Dige A, Krog J, et al. Soluble adhesion molecules correlate with surface expression in an in vitro model of endothelial activation. Basic Clin Pharmacol Toxicol. 2013; 113(4): 273–279.
  4. Weiss D, Avraham S, Guttlieb R, et al. Mechanical compression effects on the secretion of vWF and IL-8 by cultured human vein endothelium. PLoS One. 2017; 12(1): e0169752.
  5. von der Thüsen JH, Kuiper J, van Berkel TJC, et al. Interleukins in atherosclerosis: molecular pathways and therapeutic potential. Pharmacol Rev. 2003; 55(1): 133–166.
  6. Dhaun N, Webb DJ. Endothelins in cardiovascular biology and therapeutics. Nat Rev Cardiol. 2019; 16(8): 491–502.
  7. Marasciulo FL, Montagnani M, Potenza MA. Endothelin-1: the yin and yang on vascular function. Curr Med Chem. 2006; 13(14): 1655–1665.
  8. Davenport AP, Hyndman KA, Dhaun N, et al. Endothelin. Pharmacol Rev. 2016; 68(2): 357–418.
  9. Schmidt-Lucke C, Reinhold D, Ansorge S, et al. Changes of plasma concentrations of soluble vascular cell adhesion molecule-1 and vascular endothelial growth factor after increased perfusion of lower extremities in humans. Endothelium. 2003; 10(3): 159–165.
  10. Wretowski D, Krakowian M, Łabyk A, et al. Very distal transradial approach (VITRO) for coronary interventions. Postepy Kardiol Interwencyjnej. 2019; 15(1): 42–45.
  11. Levin ER. Endothelins. N Engl J Med. 1995; 333(6): 356–363.
  12. Wang DL, Tang CC, Wung BS, et al. Cyclical strain increases endothelin-1 secretion and gene expression in human endothelial cells. Biochem Biophys Res Commun. 1993; 195(2): 1050–1056.
  13. Russell FD, Skepper JN, Davenport AP. Human endothelial cell storage granules: a novel intracellular site for isoforms of the endothelin-converting enzyme. Circ Res. 1998; 83(3): 314–321.
  14. Padberg JS, Wiesinger A, di Marco GS, et al. Damage of the endothelial glycocalyx in chronic kidney disease. Atherosclerosis. 2014; 234(2): 335–343.
  15. Preston RA, Ledford M, Materson BJ, et al. Effects of severe, uncontrolled hypertension on endothelial activation: soluble vascular cell adhesion molecule-1, soluble intercellular adhesion molecule-1 and von Willebrand factor. J Hypertens. 2002; 20(5): 871–877.
  16. Wójtowicz A, Babu SS, Li Li, et al. Zyxin mediation of stretch-induced gene expression in human endothelial cells. Circ Res. 2010; 107(7): 898–902.
  17. Krieglstein C, Granger DN. Adhesion molecules and their role in vascular disease. Am J Hypertens. 2001; 14(11): S44–S54.
  18. Øynebråten I, Bakke O, Brandtzaeg P, et al. Rapid chemokine secretion from endothelial cells originates from 2 distinct compartments. Blood. 2004; 104(2): 314–320.
  19. Tang R, Zhou J, Cheng M, et al. Time-dependent increase of interleukin-8 production in endothelial cells exposed to fluid shear stress [article in Chinese]. Sheng Wu Yi Xue Gong Cheng Xue Za Zhi. 2004; 21(1): 34–37.
  20. Kim CS, Park HS, Kawada T, et al. Circulating levels of MCP-1 and IL-8 are elevated in human obese subjects and associated with obesity-related parameters. Int J Obes (Lond). 2006; 30(9): 1347–1355.
  21. Aoi S, Htun WW, Freeo S, et al. Distal transradial artery access in the anatomical snuffbox for coronary angiography as an alternative access site for faster hemostasis. Catheter Cardiovasc Interv. 2019; 94(5): 651–657.
  22. Oliveira MD, Caixeta A. Distal transradial access (dTRA) for coronary angiography and interventions: A quality improvement step forward? Case Medical Research. 2020; 32(9): E238–E239.
  23. Cai G, Huang H, Li F, et al. Distal transradial access: a review of the feasibility and safety in cardiovascular angiography and intervention. BMC Cardiovasc Disord. 2020; 20(1): 356.
  24. Davies RE, Gilchrist IC. Dorsal (distal) transradial access for coronary angiography and intervention. Interv Cardiol Clin. 2019; 8(2): 111–119.
  25. Januszek R, Siudak Z, Malinowski KP, et al. Radial versus femoral access in patients treated with percutaneous coronary intervention and rotational atherectomy. Kardiol Pol. 2020; 78(6): 529–536.
  26. Liberale L, Carbone F, Montecucco F, et al. Statins reduce vascular inflammation in atherogenesis: A review of underlying molecular mechanisms. Int J Biochem Cell Biol. 2020; 122: 105735.

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