Diagnostic value of symptomatic complaints for postoperative radial artery occlusion in patients undergoing transradial coronary catheterization

Wang Tong; Wu Lihan; Wu Suling; Gong Xiaoxuan

doi:10.26939/j.cnki.CN11-9353/R.2025.08.006

Abstract：Objective To explore the association and diagnostic value of symptomatic complaints for radial artery occlusion(RAO)in patients undergoing transradial coronary catheterization(TRC).Methods The study data were derived from a prospective cohort study,which enrolled 449 patients suspected or confirmed of coronary heart disease who underwent either elective coronary angiography(CAG)or percutaneous coronary intervention(PCI)via radial artery at the Department of Cardiology,First Affiliated Hospital of Nanjing Medical University,from January 2021 to October 2022.Any reported pain,paresthesia or weakness in the forearm on the surgical side was defined as a symptomatic complaint,and patients were divided into an asymptomatic complaint group(348 cases)and a symptomatic complaint group(101 cases).An independent ultrasound sonographer performed radial artery ultrasound examinations on patients both preoperatively and 12-24 hours post-TRC.The absence of radial artery antegrade blood flow observed using color Doppler mode was defined as RAO.The RAO incidence was compared between two groups and the association between symptomatic complaints and RAO was analyzed.Univariate and multivariate logistic regression analyses were used to explore the influencing factors for RAO in patients undergoing TRC.ROC curves were drawn to evaluate the diagnostic value of symptomatic complaints for RAO in patients undergoing TRC.Results Compared with the asymptomatic complaint group,the symptomatic complaint group showed a significantly higher incidence of RAO(26.7％vs.4.9％,P<0.001).Univariate and multivariate logistic regression analyses showed that symptomatic complaints[OR=6.453,95％CI(2.858-14.567)]and the sheath-to-artery(S/A)ratio[OR=16.272,95％CI(3.025-87.544)]were independent predictors for RAO post-TRC(P<0.05).ROC curve analysis showed that the AUCs of symptomatic complaints,S/A ratio,and their combination for predicting RAO in post-TRC patients were 0.715[95％CI(0.628-0.803)],0.691[95％CI(0.596-0.785)],and 0.769[95％CI(0.686-0.853)],respectively.Conclusion Presence of symptomatic complaints is an independent risk factor for RAO post-TRC,and the risk of RAO in patients with symptomatic complaints is 5.45 times higher than that in asymptomatic complaint patients.The symptomatic complaints and S/A ratio both show certain diagnostic value for RAO post-TRC,and the diagnostic value of their combination is higher,providing references for early detection of high-risk patients and for optimization of clinical practice and nursing strategy.