Upper Extremity Function after Transradial Percutaneous Coronary Intervention Short-Term Interim Results of the ARCUS Study

Aims: To examine the short-term effects of transradial percutaneous coronary interventions on the upper extremities function. Method and results: This is an interim analysis of the Effects of trAnsRadial perCUtaneouS coronary intervention on upper extremity function (ARCUS) study. Out of 191 patients evaluated at 2 weeks after they had undergone a transradial percutaneous coronary intervention, 120 (62.8%) had manifestations of upper extremity dysfunction on the side of the intervention. The main abnormalities were a decrease in sensibility, a ≥15% increase in the Disabilities of the Hand and Shoulder questionnaire score and a ≥2 cm increase in hand and forearm volumes. Radial artery occlusions occurred in 12 patients in the upper extremity dysfunction versus 1 patient in the no upper extremity dysfunction group (p=0.03). Patients with upper extremity dysfunction were significantly more likely to have a family history of heart disease (50% vs. 26.8%; p =0.002). In addition, there was a trend (p=0.07) toward a greater proportion of previous smokers in the group with upper extremity dysfunction than in the other group. Conclusions: Upper extremity dysfunction after transradial percutaneous coronary intervention is a medical concern. However, our original score may be overly sensitive and overestimate the rate of upper extremity dysfunction. Further analyses are needed, as well as perhaps a modification of the primary endpoint.