Hand dysfunction after transradial artery catheterization for coronary procedures

AIM To sythesize the available literature on hand dysfunction after transradial catheterization.METHODS We searched MEDLINE and EMBASE. The search results were reviewed by two independent judicators for studies that met the inclusion criteria and relevant reviews. We included studies that evaluated any transradial procedure and evaluated hand function outcomes post transradial procedure. There were no restrictions based on sample size. There was no restriction on method of assessing hand function which included disability, nerve damage, motor or sensory loss. There was no restriction based on language of study. Data was extracted, these results were narratively synthesized.RESULTS Out of 555 total studies 13 studies were finally included in review. A total of 3815 participants with mean age of 62.5 years were included in this review. A variety of methods were used to assess sensory and motor dysfunction of hand. Out of 13 studies included, only 3 studies reported nerve damage with a combined incidence of 0.16%, 5 studies reported sensory loss, tingling and numbness with a pooled incidence of 1.52%. Pain after transradial access was the most common form of hand dysfunction(6.67%) reported in 3 studies. The incidence of hand dysfunction defined as disability, grip strength change, power loss or any other hand complication was incredibly low at 0.26%. Although radial artery occlusion was not our primary end point for this review, it was observed in 2.41% of the participants in total of five studies included.CONCLUSION Hand dysfunction may occur post transradial catheterisation and majority of symptoms resolve without any clinical sequel.

开窍通络针刺法配合重复经颅磁刺激治疗脑卒中后手功能障碍临床应用研究

Objective:To observe the clinical improvement of Kāiqiàotōngluò(induce resuscitation and remove obstruction in meridians)acupuncture combined with repetitive transcranial magnetic stimulation(rTMS)in patients with hand dysfunction after stroke,and to provide evidence for its extensive application in the future.Methods:Sixty patients with the problem of hand dysfunction were divided into the observation group and the control group randomly.The two groups of patients were treated with the basic treatment,the observation group received Kdiqiaotongluo acupuncture combined with rTMS,and the control group only received the rTMS treatment.Broetz hand function scale,hemiplegic hand function grading,and modified Barthel index were used to evaluate the hand function of the patients in two groups before and after treatment.Results:After treatment,Broetz score of the patients in observation group and control group were significantly lower than that before treatment,and Broetz score of the patients in observation group was lower than that of control group(all P<0.05);As for the hemiplegic hand function grading,24 cases in the observation group improved,the improvement rate was 80.0%,and 8 cases in the control group improved,the improvement rate was only 26.7%.The improvement rate of observation group was significantly better than that of control group(P<0.01);the Barthel index scores of the observation group and the control group were significantly improved after treatment,and the observation group was better than the control group(both P<0.05).Conclusion:The Kāiqiàotōngluòacupuncture combined with rTMS can improve the hand dysfunction of patients after stroke,and it is worthy of clinical application.