Abstract

Incidence of Radial Artery Occlusion After One Year in Patients Underwent Radial Interventions with Preprocedural Patent Radial Artery by Barbeau Test and Its Comparison with the Doppler Examination

Aim of the study: To find the incidence of radial artery occlusion (RAO) at one year in patients who have radial interventions by using the Barbeau test. Materials and methods: Totally 105 patients are selected. Prior to the radial procedure oximetric Barbeau test was done in the patient’s right index finger to see the type of response. Using oximetric probe the pulse waveform is displayed with both arteries open. The radial artery is compressed and the pulse wave of the ulnar flow is observed, similarly reverse Barbeau test is performed by occluding the ulnar artery and the radial artery waveform is observed. Oximetric Barbeau test is of four grades: Type A response is no damping of pulse waveform after 2 min of artery compression with positive oximetry, type B is damping of pulse waveform with positive oximetry, followed by complete recovery within two minutes, type C response is loss of pulse waveform and negative oximetry with partial recovery of pulse waveform and oximetry within two minutes, type D response is loss of pulse waveform and negative oximetry without recovery of either pulse waveform or oximetry after two minutes of compression. Radial artery cannulation is done in type A, B and C response and not recommended in type D. Oximetric Barbeau and reverse Barbeau test was performed on the next day, on the day of discharge and every 3 months for about one year. The Barbeau test assesses the radial artery, ulnar and deep palmer arch flow patency. Other parameters affecting the radial artery patency like the number of punctures involved in radial artery cannulation, hematoma after sheath removal, size of sheath used for radial artery cannulation and the fluoro time of the procedure also had been assessed. Results: Out of 105 patients, 50 patients had type B response,14 patients had type A response, 10 patients had type C response and 31 patients developed type D (29%) response in the reverse Barbeau test. Patients who had type D response were subjected for Doppler vascular probe examination to see the patency of right radial artery, in that 19 patients (18%) had occlusion, 7 had diminished flow and another 5 had normal triphasic flow. Conclusion: The incidence of radial artery occlusion after the radial procedures in our study showed 18%, which is similar to the previous study data of 5% to 30%. Radial artery occlusion is common in patients who had hematoma, increased fluoro time and use of increased sheath size. Barbeau test alone overestimates the radial artery occlusion (RAO). So, Doppler examination is necessary and confirmatory for assessing radial artery patency.

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