Validation of High Resolution Ultrasound Measurements of Intima Media Thickness for the Assessment of Structural Remodeling following Transradial Cardiac Catheterization

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Background:

Intima media thickness (IMT) measurements of the A. carotis are routinely performed and reliabiliy and reproducibility of A. carotis IMT are well known. Transradial cardiac catheterization procedures are increasing as a result of low access-site related vascular complication rates. Radial artery (RA) IMT measurements could be used to study short and long term structural vascular adaptation following the transradial cardiac catheterization approach. However reliability and reproducibility need to be assessed before.

Objective:

Assess reliability and reproducibility of radial IMT using high-resolution ultrasound.

Methods:

Using high-resolution ultrasound, we studied Intima-Media-Thickness of both RAs in that had previously undergone transradial catheterization via the right RA. Measurements were taken at the access site (0–5cm) as well as at 5–10cm and 10–15cm proximal to access site. Measurements were repeated by the same and a second examiner. Semi-automated software-based analyses were performed by independent blinded raters.

Results:

The measurement process showed excellent reliability with a repeatability measured by the inter class correlation coefficient (ICC) of 0.911 [0.870–0.939], a high examiner and rater agreement (ICC examiner: 0.910 [0.883–0.931]; ICC rater: 0.963 [0.954–0.971]). At 6 (1–12) months, IMT was significantly increased as compared to the contralateral RA (0.30±0.056mm vs. 0.41±0.055mm, p<0.00001). IMT was similar at allsites of the ipsilateral RA.

Conclusion:

Radial Artery IMT can be measured reliably and reproducibly using high resolution ultrasound and semi-automated IMT analysis. The initial data suggest that transradial catheterization leads to long-term structural adaption processes.

Intima Media Thickness - Arteria radialis - reliability and reproducibility