Rivaroxaban versus Enoxaparin in Patients with Radial Artery Occlusion after Transradial Coronary Catheterization: A Pilot Randomization Trial

The radial artery is currently the main vascular access site for cardiac catheterization. Radial artery occlusion (RAO), although a relatively silent complication, raises concerns because of its potential impact on future procedures. This pilot randomized controlled trial compared the efficacy and safety of two anticoagulation regimens-subcutaneous enoxaparin and oral rivaroxaban-in resolving symptomatic ultrasound-confirmed RAO in 40 patients (median age 55 years [interquartile range, 48-64], including 26 female patients [70.3%]) who underwent diagnostic cardiac catheterization without requiring dual antiplatelet therapy. Thirty-seven patients completed the 28-day ultrasound-based follow-up, demonstrating comparable complete or partial resolution rates between rivaroxaban (16 of 20 patients [80.0%]) and enoxaparin (14 of 17 patients [82.3%]), with an odds ratio of 0.85 (95% confidence interval: 0.16 to 4.50). No major bleeding events occurred during the 28-day follow-up period. While rivaroxaban shows potential in resolving RAO, larger studies are necessary to validate these findings and evaluate the long-term outcomes.