Measurement of radial artery spasm using an automatic pullback device.

Area of Science:

• Cardiology
• Vascular Surgery
• Medical Devices

Background:

• Radial artery spasm (RAS) is a common complication during transradial procedures for coronary angiography and angioplasty (TRA).
• Current methods for evaluating RAS are subjective, hindering objective comparison of management strategies.
• A quantitative measure for RAS is needed to improve procedural assessment and treatment evaluation.

Purpose of the Study:

• To assess the feasibility and safety of using an automatic pullback device (APD) for transradial introducer sheath removal.
• To establish a quantitative parameter for measuring RAS.
• To correlate the measured force with clinical assessments of RAS and patient pain.

Main Methods:

• Fifty consecutive transradial procedures were analyzed.
• An automatic pullback device (APD) was employed to measure the force required for introducer sheath removal.
• Maximal pullback force (MPF) was recorded and analyzed in relation to clinical RAS and pain scores.

Main Results:

• The mean maximal pullback force (MPF) was 0.53 ± 0.52 kg, typically reached within 5 seconds.
• All patients with clinically diagnosed RAS (n=4) exhibited an MPF > 1.0 kg.
• Severe pain during sheath removal (n=3) was exclusively observed in patients with an MPF > 1.0 kg.

Conclusions:

• The use of an APD for transradial sheath removal is feasible and safe.
• The MPF measured by the APD serves as a reliable quantitative parameter for RAS.
• An MPF exceeding 1.0 kg is indicative of clinical RAS and correlates with severe procedural pain.