Risk factors of radial artery occlusion following via transradial coronary catheterization
- 1Department of Cardiology, The Affiliated Hospital of Xuzhou Medical University, 99 Huaihai West Road, Xuzhou, 221004 Jiangsu China
Abstract
Objectives: This study aimed to identify the independent risk factors associated with radial artery occlusion (RAO) after right transradial coronary angiography (CAG) or percutaneous coronary intervention (PCI), and construct a visualized nomogram for individualized RAO risk prediction.
Methods: This single-center retrospective study enrolled 561 patients with suspected angina pectoris undergoing right transradial CAG/PCI from December 2023 to June 2024; all patients received a uniform 6F radial sheath. Radial artery patency was evaluated 24 h post-procedure via modified reverse Barbeau test (MRBT). Patients were divided into RAO group (n=49) and non-RAO group (n=512). Univariate logistic regression screened candidate variables (screen threshold p<0.1), and backward stepwise multivariate logistic regression was used to identify independent predictors. A nomogram was established based on regression coefficients of independent predictors. Model performance was assessed by ROC curve (AUC), calibration curve combined with Hosmer-Lemeshow (HL) test, and decision curve analysis (DCA).
Results: The overall incidence of RAO was 8.7%. Multivariable logistic regression identified four independent risk factors for RAO: prior coronary artery disease, multiple puncture attempts, puncture duration >15 min and radial arterial spasm. The AUC of the prediction model was 0.754 (95%CI 0.671–0.837). The calibration curve showed favorable consistency between predicted and actual RAO incidence, with HL test p=0.536. DCA verified reliable clinical net benefit of the nomogram for risk stratification.
Conclusions: Four independent predictors of post-transradial RAO were confirmed:prior coronary artery disease, multiple puncture attempts, puncture duration>15min and radial arterial spasm. The nomogram built on these four factors exhibited satisfactory discrimination, calibration and clinical utility. This tool can help clinicians screen high-risk patients and deliver targeted preventive interventions, while avoiding unnecessary prophylaxis for low-risk individuals. Further prospective external validation of this model is required.
Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s13019-026-04608-6.
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BibTeX
@article{xie2026risk,
title = {{Risk factors of radial artery occlusion following via transradial coronary catheterization}},
author = {Bing Xie and Yi Teng and Hui Feng},
journal = {Journal of Cardiothoracic Surgery},
year = {2026},
month = jul,
doi = {10.1186/s13019-026-04608-6},
url = {https://doi.org/10.1186/s13019-026-04608-6},
note = {CC BY 4.0},
}
RIS
TY - JOUR
TI - Risk factors of radial artery occlusion following via transradial coronary catheterization
AU - Bing Xie
AU - Yi Teng
AU - Hui Feng
PY - 2026
DA - 2026/07/29
JO - Journal of Cardiothoracic Surgery
DO - 10.1186/s13019-026-04608-6
UR - https://doi.org/10.1186/s13019-026-04608-6
AB - Objectives: This study aimed to identify the independent risk factors associated with radial artery occlusion (RAO) after right transradial coronary angiography (CAG) or percutaneous coronary intervention (PCI), and construct a visualized nomogram for individualized RAO risk prediction. Methods: This single-center retrospective study enrolled 561 patients with suspected angina pectoris undergoing right transradial CAG/PCI from December 2023 to June 2024; all patients received a uniform 6F radial sheath. Radial artery patency was evaluated 24 h post-procedure via modified reverse Barbeau test (MRBT). Patients were divided into RAO group (n=49) and non-RAO group (n=512). Univariate logistic regression screened candidate variables (screen threshold p<0.1), and backward stepwise multivariate logistic regression was used to identify independent predictors. A nomogram was established based on regression coefficients of independent predictors. Model performance was assessed by ROC curve (AUC), calibration curve combined with Hosmer-Lemeshow (HL) test, and decision curve analysis (DCA). Results: The overall incidence of RAO was 8.7%. Multivariable logistic regression identified four independent risk factors for RAO: prior coronary artery disease, multiple puncture attempts, puncture duration >15 min and radial arterial spasm. The AUC of the prediction model was 0.754 (95%CI 0.671–0.837). The calibration curve showed favorable consistency between predicted and actual RAO incidence, with HL test p=0.536. DCA verified reliable clinical net benefit of the nomogram for risk stratification. Conclusions: Four independent predictors of post-transradial RAO were confirmed:prior coronary artery disease, multiple puncture attempts, puncture duration>15min and radial arterial spasm. The nomogram built on these four factors exhibited satisfactory discrimination, calibration and clinical utility. This tool can help clinicians screen high-risk patients and deliver targeted preventive interventions, while avoiding unnecessary prophylaxis for low-risk individuals. Further prospective external validation of this model is required. Supplementary Information: The online version contains supplementary material available at https://doi.org/10.1186/s13019-026-04608-6.
SN - 1749-8090
ER -