Key result
Female sex linked to ~3-fold higher early forearm bleeding after transradial cardiac catheterization.
Why the study?
Although transradial access is the preferred approach for coronary angiography and percutaneous coronary intervention, the influence of sex on early upper limb vascular complications remains under investigation.
Does female sex increase the incidence of early upper limb vascular complications within 24 hours compared to male sex in adult patients undergoing transradial cardiac catheterization?
Observational (n=769)
Does female sex increase the incidence of early upper limb vascular complications within 24 hours compared to male sex in adult patients undergoing transradial cardiac catheterization?
Female patients undergoing transradial cardiac catheterization experience a significantly higher rate of early forearm bleeding compared to males, highlighting the need for targeted bleeding risk mitigation strategies in women.
Background Transradial access has become the preferred approach for coronary angiography and percutaneous coronary intervention due to its safety profile. However, the influence of sex on upper limb vascular complications remains under investigation. Purpose To evaluate whether sex is associated with differences in 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 males and females. Results Of the total cohort, 600 patients (78%) were male and 169 (22%) females. Forearm bleeding was significantly more frequent in females compared with males (10.5% vs 3.8%, p=0.0015). No statistically significant differences were observed between sexes for RAO (p=0.296), hematoma (p=0.404), pain (p=0.073), paresthesia (p=0.409), non-palpable radial pulse (p=0.680), negative reverse Allen (p=0.988), negative reverse Barbeau (p=1.000), or other limb complications. Conclusion Female sex was associated with a higher incidence of early hemorrhagic complications following transradial access, whereas thrombotic and ischemic complications did not differ significantly between sexes. These findings suggest that bleeding risk mitigation strategies may be particularly relevant in female patients undergoing transradial procedures.
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Tsokkou et al. (2026) conducted an observational in Transradial coronary angiography and/or percutaneous coronary intervention (n=769). Female sex vs. Male sex was evaluated on Forearm bleeding within 24 hours (p=0.0015). Female sex was associated with higher early forearm bleeding vs male sex after transradial cardiac catheterization (10.5% vs 3.8%, p=0.0015), without significant differences in RAO or hematoma.
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