Frequency of Aberrant Right Subclavian Artery in Single Centre Patients undergoing Coronary Angiogram via Radial Artery Approach

Farhat Ullah Khan; Ejaz Ullah; Muhammad Idrees Khan; Farhana Rashid; Muhammad Musa

doi:10.70749/ijbr.v3i2.734

Authors

Farhat Ullah Khan Department of Cardiology, Hayatabad Medical Complex, Peshawar, KP, Pakistan.
Ejaz Ullah Department of Medicine and Allied, Khyber Teaching Hospital, Peshawar, KP, Pakistan.
Muhammad Idrees Khan Department of Cardiology, Hayatabad Medical Complex, Peshawar, KP, Pakistan.
Farhana Rashid Department of Medicine and Allied, Khyber Teaching Hospital, Peshawar, KP, Pakistan.
Muhammad Musa Department of Medicine and Allied, Khalifa Gul Nawaz Teaching Hospital MTI, Bannu, KP, Pakistan.

DOI:

https://doi.org/10.70749/ijbr.v3i2.734

Keywords:

ARSA, CAG, Radial Artery, Procedural Success, Peshawar

Abstract

Objective: To determine the frequency of ARSA in patients undergoing CAG via the radial artery approach at Hayatabad Medical Complex, Peshawar. The study also aimed to assess the impact of ARSA on the procedural success rate. Methodology: This retrospective study included 500 patients who underwent CAG between January 2023 and December 2023. Data were collected from medical records, angiographic reports, and pre-procedural imaging, including CTA. Statistical analysis was performed using the Chi-square test to assess the relationship between ARSA and procedural success. Results: The study found that 60% of the patients were diagnosed with ARSA, and 40% were not. The success rate of CAG via the radial artery approach was 80%, with 20% requiring femoral artery access. A statistically significant relationship was found between ARSA and the success of radial artery access (p-value = 0.04). The most common comorbidities were hypertension (37%), diabetes (25%), and cholesterol (18%). The p-value for the association between comorbidities and ARSA was 0.12. Conclusion: ARSA is prevalent in a significant proportion of patients undergoing CAG via the radial artery approach. Pre-procedural imaging, such as CTA, is crucial for detecting ARSA and improving procedural success. The study highlights the importance of considering alternative access routes in patients with ARSA to minimize complications.

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References

KUMAR, B., SONI, S., & SINGH, A. (2021). Right coronary artery intervention through right radial access in a patient with aberrant right subclavian artery and anomalous origin of right coronary artery. Heart India, 9(3), 188-190. https://doi.org/10.4103/heartindia.heartindia_85_21

Wang, P., Wang, Q., Bai, C., & Zhou, P. (2020). Iatrogenic aortic dissection following transradial coronary angiography in a patient with an aberrant right subclavian artery. Journal of International Medical Research, 48(8). https://doi.org/10.1177/0300060520943789

Tanaka, T., Sashida, R., Hirokawa, Y., & Matsuno, A. (2023). Aberrant Right Subclavian Artery Identified before Carotid Artery Stenting. JMA Journal, 6(3). https://doi.org/10.31662/jmaj.2023-0049

Nedelcu, A. H., Lupu, A., Moraru, M. C., Tarniceriu, C. C., Stan, C. I., Partene Vicoleanu, S. A., Haliciu, A. M., Statescu, G., Ursaru, M., Danielescu, C., Ioniuc, I., Tepordei, R. T., & Lupu, V. V. (2024). Morphological aspects of the aberrant right subclavian artery—A systematic review of the literature. Journal of Personalized Medicine, 14(4), 335. https://doi.org/10.3390/jpm14040335

Irakleidis, F., Kyriakides, J., & Baker, D. (2021). Aberrant right subclavian artery – a rare congenital anatomical variation causing dysphagia lusoria. Vasa, 50(5), 394-397. https://doi.org/10.1024/0301-1526/a000904

Stavridis, K., Antsaklis, P., Theodora, M., Tasias, K., & Daskalakis, G. (2022). Prenatal diagnosis of aberrant right subclavian artery: A literature review. The Journal of Maternal-Fetal & Neonatal Medicine, 35(25), 8856-8862. https://doi.org/10.1080/14767058.2021.2005570

Latif, A., Khalil, M. S., Ullah, S., Parvez, M., & Shah, H. A. (2022). Prevalence and pattern of congenital coronary artery anomalies in patients undergoing coronary angiography at a tertiary care hospital. Pakistan Journal of Medical and Health Sciences, 16(12), 245-248. https://doi.org/10.53350/pjmhs20221612245

Polguj, M., Stefanczyk, L., & Topol, M. (2016). The epidemiological, morphological, and clinical aspects of the aberrant right subclavian artery (Arteria Lusoria). Epidemiology of Communicable and Non-Communicable Diseases - Attributes of Lifestyle and Nature on Humankind. https://doi.org/10.5772/64604

Farooq, W., Khan, R., & Page, B. (2023). Abstract 17923: Acute limb ischemia due to dissection and thrombosis of anomalous right subclavian artery: A rare complication of trans-radial PCI. Circulation, 148(Suppl_1). https://doi.org/10.1161/circ.148.suppl_1.17923

Oliveira, M. D., Navarro, E. C., & Caixeta, A. (2021). Distal transradial access for post-CABG coronary and surgical grafts angiography and interventions. Indian Heart Journal, 73(4), 440-445. https://doi.org/10.1016/j.ihj.2021.06.005

Sucu, M., Özsürmeli, M., Arslan, E., Demir, C., & Evrüke, C. (2020). The associtation between aberrant right subclavian artery and trisomy 21 in a tertiary center in Turkey. Ginekologia Polska, 91(8), 460-464. https://doi.org/10.5603/gp.2020.0078

Oliveira, M. D., Navarro, E. C., De Sá, G. A., & Caixeta, A. (2021). Unprotected left main primary PCI via distal Transradial access in the setting of STEMI-related Cardiogenic shock. Heart Views, 22(2), 146-149. https://doi.org/10.4103/heartviews.heartviews_185_2

Tanka, M., Kristo, A., Leka, N., & Kristo, A. (2022). Aberrant right subclavian artery. A series of case reports and discussion of morphology and its clinical and surgical implications. International Journal of Morphology, 40(4), 1123-1127. https://doi.org/10.4067/s0717-95022022000401123

Zingarelli, A., Morelli, M. C., Seitun, S., Bezante, G. P., Balbi, M., & Brunelli, C. (2015). Aberrant right subclavian artery (Arteria Lusoria) challenging 4-French Homolateral Transradial coronary catheterisation in adulthood. Heart, Lung and Circulation, 24(10), e164-e168. https://doi.org/10.1016/j.hlc.2015.04.172

Oliveira, M. D., Navarro, E., De Sa, G., Santos, G., Garcia, M., Viana, R., & Caixeta, A. (2021). Complex coronary intervention via right distal Transradial access with Lusoria subclavian artery under refractory electrical storm: A really challenging case. Journal of Invasive Cardiology, 33(1). https://doi.org/10.25270/jic/20.00056

Chowdhury, Y., A. Shaikh, S., Salman, A., D. Marmur, J., & M. McFarlane, I. (2020). Aberrant right subclavian artery and Stanford type B aortic dissection. American Journal of Medical Case Reports, 8(8), 247-249. https://doi.org/10.12691/ajmcr-8-8-9