Angiographic Evaluation of Right Upper-Limb Arterial Anomalies: Implications for Transradial Coronary Interventions

作者：Fujii Toshiharu; Masuda Naoki; Tamiya Seiji; Shima Makiyoshi; Toda Eri; Ito Daiki; Nakazawa Gaku; Matsukage Takashi; Ogata Nobuhiko; Morino Yoshihiro; Tanabe Teruhisa; Ikari Yuji^*

来源：Journal of Invasive Cardiology, 2010, 22(11): 536-540.

• upper limb
• arterial anomaly
• transradial coronary intervention
• antegrade
• angiography

Objectives Upper limb arterial anomalies are sometimes encountered during transradial coronary procedures These anomalies may contribute to procedural failure or to vascular complications and are a major reason why many operators tend to avoid transradial procedures We investigated the frequency of right upperlimb arterial anomalies using antegrade arteriography in patients undergoing transbrachial coronary angiography or intervention and discuss the potential impact of these anomalies on the transradial procedure Methods We prospectively studied 163 consecutive patients who underwent right transbrachial coronary angiography or intervention for the first time during the period from May 2007 to December 2007 Following the transbrachial procedure we performed antegrade transbrachial arteriography of right upper limb arteries in these patients and investigated the frequency and anatomy of arterial anomalies Results A total of 40 upper limb arterial anomalies were observed in 38 patients (23 3%) These Included 8 abnormal origins (4 9%) 2 radio-ulnar loops (1 2%) 25 tortuosities (15 3%) 4 stenoses (2 5%) and 1 loop (0 6%) In patients with congenital lesions (8 patients 4 9%) abnormal origin of the radial artery was the most common anomaly encountered and in the acquired group (25 patients 15 3%) tortuosity was the most common abnormality Conclusion Even with a 23 3% incidence of right upper-limb arterial abnormalities 98 8% of patients were acceptable for transradial coronary intervention except for 1 2% of radio-ulnar loops

• 出版日期2010-11