Impact of age on early upper limb vascular complications after transradial cardiac catheterization. A sub-study of the LOW-RAO study

Background Although transradial access is considered safe across age groups, elderly patients may present increased vascular vulnerability. The effect of age on upper limb vascular complications remains unclear. Purpose To assess whether age ≥70 years is associated with increased early upper limb vascular complications following transradial cardiac catheterization. Methods A total of 769 consecutive adult patients (mean age 65±12 years, 22% females), undergoing transradial coronary angiography and/or percutaneous coronary intervention that were screened for the LOW-RAO study were analyzed. Upper limb vascular complications within 24 hours were systematically recorded and compared between older (age ≥70 years) and younger patients (age <70 years). Results Radial artery spasm was significantly more frequent in patients aged ≥70 years compared with younger patients (p=0.012). No significant differences were observed between age groups for radial artery occlusion (p=0.477), haematoma (p=0.368), bleeding (p=0.254), pain (p=0.665), non-palpable radial pulse (p=0.580), negative reverse Allen (p=0.305), negative reverse Barbeau (p=0.181), or other vascular complications. Conclusion Advanced age was associated with a higher incidence of radial artery spasm but not with increased thrombotic or hemorrhagic complications. These findings support the overall safety of transradial access in elderly patients while highlighting the need for careful management of vasospasm in this population.