Risk factors of access site pain following coronary interventions through upper extremities

Introduction: Coronary artery disease (CAD) is recognized as the major cause of mortality and morbidity worldwide. Coronary artery interventions are considered the best therapeutic choice for most patients. Similar to other invasive procedures, these interventions whether performed from femoral or upper extremities have their own complications. There is a paucity of studies regarding access site pain and its related factors as a common complication of coronary intervention. With this background in mind, the present study aimed to determine the prevalence and the risk factors associated withthe development of upper extremity pain following coronary artery interventions. Material and methods: The present cross sectional studywas conductedin Ghaem and Imam-Reza hospitals (Mashhad, Iran) from July to December 2019. Every patient who underwent coronary intervention using radial and ulnar arterieswere enrolled in the present study, and the development of pain on the first day of intervention was evaluated. The relationship between upper extremity pain after the procedure and the study variables was assessed using Chi-square and Fisher’s exact tests. A p-value less than 0.05 was considered statistically signi8icant. Results: Most of 370 patients who underwent coronary artery angiography were male (n=202; 54.6%), and the cardiovascular risk factors were not signi8icantly different betweenthe patients who developed upper extremity pain and those who did not. Upper extremity pain was detectedin 43.8% of patients within their 8irst day after the procedure. Most of the patients reported pain at the puncture site (n=80). The female gender and the development of hematoma were significantly related to experiencing upper extremity pain (P 0.001 both). Conclusion: There is a paucity of studies regarding the upper extremity pain following coronary intervention. The present study demonstrated that approximately 44% of patients who undergo coronary intervention on their upper extremities will experience upper extremity pain mostly at the puncture site within their first day after the surgery. Planning specific pre-procedure management program for female patients who are most likely to develop pain may be of great help in reducing the limb pain following the procedure.