Predictors of Radial Artery Size in Patients Undergoing Cardiac Catheterization: Insights From the Good Radial Artery Size Prediction (GRASP) Study
Predictors of Radial Artery Size in Patients Undergoing Cardiac Catheterization: Insights From the Good Radial Artery Size Prediction (GRASP) Study
复制标题
DOI：
10.1016/j.cjca.2013.11.021
复制
发表时间：
2014-02-01
影响因子：
6.2
通讯作者：
Dzavik, Vladimir
中科院分区：
文献类型：
--
作者：
Kotowycz, Mark A.;Johnston, K. Wayne;Dzavik, Vladimir
背景：桡动脉闭塞发生在经桡动脉心导管插入术或经皮冠状动脉介入治疗后。尽管使用大于动脉的鞘管是桡动脉闭塞的一个风险因素，但桡动脉尺寸未进行常规测量。我们的目的是确定床旁预测桡动脉diameter.Methods：使用超声，我们前瞻性地测量桡动脉，尺动脉和肱动脉直径的130例择期经皮冠状动脉介入治疗或诊断性血管造影。使用预先指定的候选变量，我们使用多变量线性回归，以确定桡动脉diameter.Results的预测：右桡动脉，尺动脉和肱动脉的平均内径分别为2.44 +/- 0.60，2.14 +/- 0.53，和4.50 +/- 0.88毫米，分别。左臂的结果相似。男性患者的右桡动脉大于女性患者（2.59 mm vs 1.91 mm; P < 0.001），南亚裔患者的右桡动脉小于女性患者（2.00 mm vs 2.52 mm; P < 0.001）。桡动脉直径与手腕周长（r（2）= 0.26; P < 0.001）和鞋子尺寸（r（2）= 0.25; P < 0.001）相关，与身高（r（2）= 0.14; P < 0.001）、体重（r（2）= 0.18; P < 0.001）、体重指数（r（2）= 0.07; P = 0.002）和体表面积（r（2）= 0.22; P < 0.001）。桡动脉较大的独立预测因子为腕围（r（2）= 0.26; P < 0.001）、男性（r（2）= 0.06; P < 0.001）和非南亚血统（r（2）= 0.05; P = 0.006;最终模型r（2）= 0.37; P < 0.001）。使用这些变量的风险评分预测桡动脉直径（c-统计，0.71）。结论：手腕周长，男性，和非南亚血统的桡动脉直径增加的独立预测因子。使用这些变量的风险评分可以识别桡动脉小的患者。
Background: Radial artery occlusion occurs after transradial cardiac catheterization or percutaneous coronary intervention. Although use of a sheath larger than the artery is a risk factor for radial artery occlusion, radial artery size is not routinely measured. We aimed to identify bedside predictors of radial artery diameter.Methods: Using ultrasound, we prospectively measured radial, ulnar, and brachial artery diameters of 130 patients who presented for elective percutaneous coronary intervention or diagnostic angiography. Using prespecified candidate variables we used multivariable linear regression to identify predictors of radial artery diameter.Results: Mean internal diameters of the right radial, ulnar, and brachial arteries were 2.44 +/- 0.60, 2.14 +/- 0.53, and 4.50 +/- 0.88 mm, respectively. Results for the left arm were similar. The right radial artery was larger in men than in women (2.59 vs 1.91 mm; P < 0.001) and smaller in patients of South Asian descent (2.00 vs 2.52 mm; P < 0.001). Radial artery diameter correlated with wrist circumference (r(2) = 0.26; P < 0.001) and shoe size (r(2) = 0.25; P < 0.001) and weakly correlated with height (r(2) = 0.14; P < 0.001), weight (r(2) = 0.18; P < 0.001), body mass index (r(2) = 0.07; P = 0.002), and body surface area (r(2) = 0.22; P < 0.001). The independent predictors of a larger radial artery were wrist circumference (r(2) = 0.26; P < 0.001), male sex (r(2) = 0.06; P < 0.001), and non-South Asian ancestry (r(2) = 0.05; P = 0.006; final model r(2) = 0.37; P < 0.001). A risk score using these variables predicted radial artery diameter (c-statistic, 0.71).Conclusions: Wrist circumference, male sex, and non-South Asian ancestry are independent predictors of increased radial artery diameter. A risk score using these variables can identify patients with small radial arteries.