Prevention of radial artery occlusion with rivaroxaban after trans-radial access coronary procedures: The RIVARAD multicentric randomized trial

Frontiers in Cardiovascular Medicine

Cardiovascular Medicine

Slim Abid¹  Souad Mallek¹  Zied Triki¹  Leila Abid²  Rania Hammami²  Faten Triki²  Selma Charfeddine²  Amine Kammoun²  Aymen Ben Abdessalem³  Samia Ernez Hejri³  Hicheme Denguir⁴  Imtinene Ben Mrad⁵  Sondos Kraeim⁵  Mehdi Slim⁶  Ilyes Naffeti⁶  Houssem Thabet⁶  Marwen Kacem⁶  Jdidi Jihen⁷ 

[1] Cardiology Department, Hedi Chaker Hospital, Sfax, Tunisia;Cardiology Department, Hedi Chaker Hospital, Sfax, Tunisia;University of Sfax, Sfax, Tunisia;Faculty of Medicine, University of Sfax, Sfax, Tunisia;Centre Hôpital Universitaire Farhat Hached, Sousse, Tunisia;Gabes University, Gabès, Tunisia;Habib Hospital Thameur, Tunis, Tunisia;Hôpital Sahloul, Sousse, Tunisia;University of Sfax, Sfax, Tunisia;Faculty of Medicine, University of Sfax, Sfax, Tunisia;Epidemiology Department, Hedi Chaker Hospital, Sfax, Tunisia;

关键词: trans-radial access;    radial artery occlusion;    rivaroxaban;    Doppler ultrasound;    hemorrhagic complications;   

DOI  :  10.3389/fcvm.2023.1160459

 received in 2023-02-07, accepted in 2023-03-27,  发布年份 2023

来源: Frontiers

【 摘 要 】

BackgroundRadial artery occlusion (RAO) remains the most frequent complication of trans-radial access. Once the radial artery is occluded, its future use as an access site for coronary procedures, or as a conduit for coronary bypass grafting or fistula for hemodialysis, will be precluded. Therefore, we aimed to assess the value of the short-term use of Rivaroxaban to prevent RAO after a trans-radial coronary procedure.MethodsThis was a prospective, open-label, randomized study. The patients were randomly assigned (1:1) to one of two groups: those who received Rivaroxaban 10 mg for 7 days following the trans-radial coronary procedure (the Rivaroxaban Group) and those who received the standard treatment (the Control Group). The primary outcome was an occurrence of RAO evaluated by Doppler ultrasound at 30 days, and the secondary outcomes were hemorrhagic complications according to BARC classification.ResultsWe included 521 patients randomized into two Groups: the Control Group (N = 262) and the Rivaroxaban Group (N = 259). The 1-month RAO was significantly reduced in the Rivaroxaban Group as compared to the Control Group [6.9% vs. 13%; p = 0.011, OR = 0.5, (95% CI, 0.27–0.91)]. We noted no cases of severe bleeding events (BARC3-5). The overall incidence of minor bleeding (BARC1) was 2.3%, with no significant difference between the two groups [Rivaroxaban Group = 2.7%, Control Group = 1.9%, p = 0.54, OR= 1.4, (95%CI 0.44–4.5)].ConclusionsShort-term postoperative anticoagulation with Rivaroxaban 10 mg for seven days reduces the rate of 1-month RAO.

【 授权许可】

Unknown   
© 2023 Hammami, Abid, Jihen, Triki, Ben Mrad, Kammoun, Slim, kacem, Thabet, Abdessalem, Mallek, Charfeddine, Triki, Hejri, Naffeti, Denguir, Kraeim and Abid.