The rate of symmetric complex anatomy of the arms’ arteries in the conversion from the right to the left radial approach, assessed by the data of the open registry COMPAAS (COMPlex Anatomy of Arteries and Symmetry)

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Abstract

Background. Complex anatomy of the arms’ arteries is the most frequent cause of complications and failures occurring with transradial approach. Aim. To study the rate of symmetric complex arterial anatomy in both arms for the choice of an optimal and safe way of approach conversion in cases of right transradial approach failure. Material and methods. From January, 2018 to January, 2019, a total of 157 cases of complex arterial anatomy of the right arm were included in the registry: high origin of a. radialis (84); complete loop or tortuosity (66) and diffuse calcification of the arm’s arteries (7). The arterial anatomy of the left arm was studied with angiography. Results. The duplication of high bifurcation (with a. radialis arising from a. brachialis) in both arms was revealed in 20.9% (13/62); with a. radialis arising from a. axillaris, the symmetric arterial anatomy of both arms was half as frequent - in 9% (2/22). The symmetric marked tortuosity or complete loop in both arms was revealed in 54%, herewith in 25% of cases marked tortuosity was accompanied by the high origin of a. radialis. Bilateral total severe calcification of the arms’ arteries was seen in 85.7% of cases. Conclusion. In cases with total severe calcification or marked tortuosity of the high raised right a. radialis we recommend to perform the conversion to transfemoral approach because the rate of symmetry of such cases is high. In cases of the isolated high origin of the right a. radialis, the risk of facing similar problems with the left side is quite low and depend on level of a. radialis’s arising (7-20%).

About the authors

Sergei P. Semitko

I.M. Sechenov First Moscow State Medical University (Sechenov University)

D. Sci. (Med.), Prof. Moscow, Russia

Ilia S. Melnichenko

Mytishchi City Clinical Hospital

Email: ilyamel55@gmail.com
doctor for endovascular diagnosis and treatment Mytishchi, Russia

Marina I. Karpeeva

NORBIT

Email: kamarik@list.ru
Head of software development Department Moscow, Russia

Pavel A. Bolotov

V.V. Veresaev City Clinical Hospital

Email: dr.bolotov@mail.ru
D. Sci. (Med.), Prof. Moscow, Russia

Anton I. Analeev

Mytishchi City Clinical Hospital

Email: anton-analeev@yandex.ru
Head of Department Mytishchi, Russia

Aleksei V. Azarov

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: azarov_al@mail.ru
Cand. Sci. (Med.) Moscow, Russia

Sergei V. Kruk

V.V. Veresaev City Clinical Hospital

Email: kruksergey1889@gmail.com
doctor for endovascular diagnosis and treatment Moscow, Russia

Vitalii P. Klimov

V.V. Veresaev City Clinical Hospital

Email: vp_klimov@mail.ru
Cand. Sci. (Med.) Moscow, Russia

Vladimir V. Sorokin

V.V. Veresaev City Clinical Hospital

Email: voldemar86@list.ru
doctor for endovascular diagnosis and treatment Moscow, Russia

David G. Ioseliani

I.M. Sechenov First Moscow State Medical University (Sechenov University)

Email: davidgi@mail.ru
D. Sci. (Med.), Prof., Acad. RAS Moscow, Russia

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