Radial Angiogram Procedure and Complications

Cardiac catheterization refers to a minimum invasion procedure used commonly for diagnosing and treatment of complicated heart conditions. During the process of catheterization, cardiac surgeons place small tubes called catheters into the patients’ circulatory system under the X-ray guidance with the objective to get relevant information about heart pressures and flow of blood. In addition, the process intends to determine the obstructions (if any) present within the person’s blood vessels responsible for feeding the heart muscles or coronary arteries.

Doctors insert the catheters required in the cardiac catheterization process either in the groin or femoral artery or in the wrist or radial artery. When the doctors perform the process by inserting catheters or small tubes in the radial artery, they call it radial angiogram procedure.

Before starting the actual radial angiogram procedure, concerned doctors/surgeons test the supply of blood to the hand of their patients. Ulnar artery and radial artery are the two arteries responsible for supplying the blood to the individuals’ hand and when both of them work properly, doctors conclude that it is safe to go ahead with the actual catheterization procedure.

Now, the doctor will choose either of the wrists to perform the actual radial angiogram procedure. Here, doctors choose one side depending on a few valid reasons.

However, in rare cases, they choose both the wrist / radial and groin i.e. femoral arteries to perform catheterization, particularly, when arteries present in the patient’s arm do not allow the small tubes to connect to the heart easy way.

At the same time, nurse administers the required medication from a vein to sedate the patients, while cardiologist gives local anesthetic to the person’s wrist and finally insert a catheter via a sheath in the radial artery. Doctors also give the necessary medications from the tube to allow relaxation of radial artery, which may lead to temporary burning sensation in the arm and in the hand.

Other than this, doctors may sometimes use a blood thinner to avoid the formation of clots in the radial artery. After completion of the entire radial angiogram procedure, doctors remove the sheath and the catheter from the respective radial artery, while place a suitable compression device over the wrist. After keeping device for about 2 hours, patients may sit and have food after the entire radial angiogram procedure.

Until now, cardiologists and medical researchers have found the two major complications associated with the radial angiogram procedure.

1. Complication of Radial Artery Occlusion

   In radial angiogram procedure, a radial artery occlusion complication takes place whenever formation of clot takes place in the radial artery and it results in blockage of the antegrade flow of the blood. This type of clotting takes place due to irritation of blood vessels or injury and it may take place either at the time of insertion or removal of sheath leading to thrombosis and spasm. Primary consequence of this problem is that it avoids repeat access from one’s occluded arteries.

2. Complication of Radial Artery Spasm

   In radial angiogram procedure, a radial artery spasm complication takes place because of the medial layer presents in the artery of a patient, which is highly reactive because of the increase in the smooth muscular contents present in the wall of arteries. When spasm takes place, it causes excessive pain in the forearm of the patient and prevents both advancement and removal of the introducer sheath or the catheter. In some of the cases, doctors may easily reverse the process by using antispasmodic drugs, while in extreme cases; it mandates conversion to another radial artery or access to the femoral artery.

Also Read:

• How is Angiogram Done & How Long Does it Take to Do an Angiogram?
• What is an Angiogram, Know It’s Use, Types & How Safe is it?
• What is Coronary Angiogram, Why is it Done, Its Risks & Its Report?
• How is Angiogram Performed, Know It’s After Effect, Side Effects, Complications?
• Is Angiogram Safe for Elderly?