Objectives. To determine the incidence of upper extremity dysfunction (UED), after a transradial percutaneous coronary intervention (TR-PCI). Background. Transradial approach (TRA) is the preferred approach for coronary interventions. However, upper extremity complications may be underreported. Methods. The ARCUS was designed as a prospective cohort study, including 502 consecutive patients admitted for PCI. Patients treated with transfemoral PCI (TF-PCI) acted as a control group. A composite score of physical examinations and questionnaires was used for determining UED. Clinical outcomes were monitored during six months of follow-up, with its primary endpoint at two weeks. Results. A total of 440 TR-PCI and 62 control patients were included. Complete case analysis (n = 330) at 2 weeks of follow-up showed that UED in the TR-PCI group was significantly higher than that in the TF-PCI group: 32.7% versus 13.9%, respectively (). The three impaired variables most contributing to UED were impaired elbow extension, wrist flexion, and extension. Multivariate logistic regression showed that smokers were almost three times more likely to develop UED. Conclusions. This study demonstrates that UED seems to occur two times more in TR-PCI than in TF-PCI at 2 weeks of follow-up. However, no significant long-term difference or difference between the intervention arm and the contralateral arm was found at all timepoints.

中文翻译：

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经桡动脉经皮冠状动脉介入治疗后的上肢功能：ARCUS 试验结果

目标。确定经桡动脉经皮冠状动脉介入治疗 (TR-PCI) 后上肢功能障碍 (UED) 的发生率。背景。经桡动脉入路 (TRA) 是冠状动脉介入治疗的首选方法。然而，上肢并发症可能被低估。方法。ARCUS 被设计为一项前瞻性队列研究，包括 502 名连续接受 PCI 的患者。接受经股动脉 PCI (TF-PCI) 治疗的患者作为对照组。体格检查和问卷的综合评分用于确定 UED。在六个月的随访期间监测临床结果，其主要终点为两周。结果. 总共包括 440 名 TR-PCI 和 62 名对照患者。随访 2 周的完整病例分析（n  = 330）显示，TR-PCI 组的 UED 显着高于 TF-PCI 组：分别为 32.7% 和 13.9%（）。对 UED 影响最大的三个受损变量是肘部伸展、腕部屈曲和伸展受损。多变量逻辑回归表明，吸烟者患 UED 的可能性几乎是其三倍。结论。这项研究表明，在 2 周的随访中，TR-PCI 中 UED 的发生率似乎是 TF-PCI 中的两倍。然而，在所有时间点均未发现干预臂和对侧臂之间存在显着的长期差异或差异。