Management and Nursing of Access-site Vascular Complications after Trans-radial Percutaneous Coronary Procedures_West China Medical Journal

Authors：

 WANGYao ¹ , YANGLi-chao ² , WENBi ¹ , HEZe-xia ¹ ,  RENYu-ying ¹

1. Department of Cardiology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;
2. Department of Neurology, West China Hospital, Sichuan University, Chengdu, Sichuan 610041, P. R. China;

Corresponding author：

RENYu-ying, Email: renyuy6507@163.com

Keywords：

Trans-radial access; Access-site vascular complications; Nursing

DOI：

10.7507/1002-0179.20140640

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Objective To discuss the importance of early identification and effective management of puncture-associated complications after trans-radial percutaneous coronary procedures. Methods A total of 698 patients undergoing trans-radial percutaneous coronary procedures from June to December 2012 were included and followed up. The puncture associated complications and their clinical managements were summarized in the present study. Results We found that trans-radial approach was safe. The main puncture-associated complications included access-site pain, tension blisters and hemorrhagic complication. Complications with severe clinical consequence were rare. Most of the complications could be successfully treated with conservative management including access-site nursing and psychological nursing. Conclusion Trans-radial approach is safe for percutaneous coronary procedures, but close clinical monitoring and nursing are essential.

Citation： WANGYao, YANGLi-chao, WENBi, HEZe-xia, RENYu-ying. Management and Nursing of Access-site Vascular Complications after Trans-radial Percutaneous Coronary Procedures. West China Medical Journal, 2014, 29(11): 2125-2127. doi: 10.7507/1002-0179.20140640 Copy

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5.	屠艳梅, 王秋池. 经桡动脉行冠状动脉介入治疗后并发张力性水泡的原因分析及护理对策[J]. 实用临床医药杂志, 2011, 15(22):63-64, 66.
6.	Jolly SS, Yusuf S, Cairns J et al. Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL):a randomised, parallel group, multicentre trial[J]. Lancet, 2011, 377(9775):1409-1420.
7.	Jolly SS, Amlani S, Hamon M, et al. Radial versus femoral access for coronary angiography or intervention and the impact on major bleeding and ischemic events:a systematic review and meta-analysis of randomized trials[J]. Am Heart J, 2009, 157(1):132-140.
8.	郭盛. 冠状动脉病变经桡动脉途径介入治疗临床研究[J]. 华西医学, 2010, 25(10):1789-1891.
9.	徐英, 何森, 游桂英, 等. 经桡动脉穿刺行冠状动脉介入治疗围手术期护理[J]. 华西医学, 2011, 26(11):1711-1712.
10.	Bertrand OF. Acute forearm muscle swelling post transradial catheterization and compartment syndrome:prevention is better than treatment[J]. Catheter Cardiovasc Interv, 2010, 75:366-368.
11.	Burzotta F, Mariani L, Trani C, et al. Management and timing of access-site vascular complications occurring after trans-radial percutaneous coronary procedures[J]. Int J Cardiol, 2013, 167(5):1973-1978.
12.	Burzotta F, Trani C, Mazzari MA, et al. Vascular complications and access crossover in 10676 transradial percutaneous coronary procedures[J]. Am Heart J, 2012, 163(2):230-238.
13.	Nathan S, Rao SV. Radial versus femoral access for percutaneous coronary intervention:implications for vascular complicationsand bleeding[J]. Curr Cardiol Rep, 2012, 14(4):502-509.

1. Campeau L. Percutaneous radial artery approach for coronary angiography[J]. Cathet Cardiovasc Diagn, 1989, 16(1):3-7.
2. Kiemeneij F, Laarman GJ. Percutaneous transradial artery approach for coronary stent implantation[J]. Cathet Cardiovasc Diagn, 1993, 30(2):173-178.
3. Biondi-Zoccai GG, Moretti C, Omede P, et al. Intra-arterial lidocaine versus saline to reduce peri-procedural discomfort in patients undergoing percutaneous trans-radial or trans-ulnar coronary procedures[J]. Acta cardiologica, 2011, 66(1):9-14.
4. Levine GN, Bates ER, Blankenship JC, et al. 2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention:a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions[J]. Circulation, 2011, 124(23):e574-e651.
5. 屠艳梅, 王秋池. 经桡动脉行冠状动脉介入治疗后并发张力性水泡的原因分析及护理对策[J]. 实用临床医药杂志, 2011, 15(22):63-64, 66.
6. Jolly SS, Yusuf S, Cairns J et al. Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL):a randomised, parallel group, multicentre trial[J]. Lancet, 2011, 377(9775):1409-1420.
7. Jolly SS, Amlani S, Hamon M, et al. Radial versus femoral access for coronary angiography or intervention and the impact on major bleeding and ischemic events:a systematic review and meta-analysis of randomized trials[J]. Am Heart J, 2009, 157(1):132-140.
8. 郭盛. 冠状动脉病变经桡动脉途径介入治疗临床研究[J]. 华西医学, 2010, 25(10):1789-1891.
9. 徐英, 何森, 游桂英, 等. 经桡动脉穿刺行冠状动脉介入治疗围手术期护理[J]. 华西医学, 2011, 26(11):1711-1712.
10. Bertrand OF. Acute forearm muscle swelling post transradial catheterization and compartment syndrome:prevention is better than treatment[J]. Catheter Cardiovasc Interv, 2010, 75:366-368.
11. Burzotta F, Mariani L, Trani C, et al. Management and timing of access-site vascular complications occurring after trans-radial percutaneous coronary procedures[J]. Int J Cardiol, 2013, 167(5):1973-1978.
12. Burzotta F, Trani C, Mazzari MA, et al. Vascular complications and access crossover in 10676 transradial percutaneous coronary procedures[J]. Am Heart J, 2012, 163(2):230-238.
13. Nathan S, Rao SV. Radial versus femoral access for percutaneous coronary intervention:implications for vascular complicationsand bleeding[J]. Curr Cardiol Rep, 2012, 14(4):502-509.

West China Medical Journal

Management and Nursing of Access-site Vascular Complications after Trans-radial Percutaneous Coronary Procedures

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