Related Experiment Video
Updated: May 30, 2026
Ultrasound Assessment of Endothelial-Dependent Flow-Mediated Vasodilation of the Brachial Artery in Clinical Research
Published on: October 22, 2014
Effects of coronary angiography and femoral arterial access on endothelial functions
Murat Tulmaç1, Nurtaç Ozer, Vedat Simşek
1Department of Cardiology, Kırıkkale University School of Medicine, Kırıkkale, Turkey. mtulmac@yahoo.com
Insights
Femoral arterial sheath insertion during coronary angiography temporarily impairs endothelial function, particularly in patients with normal coronary arteries. Coronary angiography itself does not cause endothelial dysfunction.
Area of Science:
- Cardiovascular Medicine
- Endothelial Function Research
- Interventional Cardiology
Background:
- Endothelial dysfunction is a key predictor of coronary events.
- Understanding procedural impacts on endothelial function is crucial for patient outcomes.
Purpose of the Study:
- To investigate the effects of arterial access and coronary angiography on endothelial function.
- To determine if coronary angiography induces endothelial vasomotor dysfunction.
Main Methods:
- Assessed brachial artery flow-mediated dilatation in 18 stable angina patients.
- Measurements were taken before, during (femoral sheath insertion), and after coronary angiography.
Main Results:
- Femoral sheath insertion significantly reduced flow-mediated dilatation (P < 0.007).
- Endothelial function recovered post-procedure, with no significant difference from baseline.
- The reduction in endothelial function was more pronounced in patients without coronary artery disease.
Conclusions:
- Coronary angiography does not cause endothelial vasomotor dysfunction.
- Femoral arterial sheath insertion is linked to transient endothelial dysfunction.
- Further research is needed on atherosclerosis's role in endothelial response to arterial injury.
Background:
Impairment of endothelial function is an independent predictor of coronary events. The aim of this study was to clarify the influence of arterial access and coronary angiography on endothelial function.
Methods:
Eighteen patients with stable angina pectoris who underwent coronary angiography were included in this study. Brachial artery flow-mediated dilatation of patients was measured before angiography, after femoral arterial sheath insertion, and after coronary angiography.
Results:
Of 18 patients, 11 had angiographically apparent atherosclerosis. Flow-mediated dilatation after femoral arterial sheath insertion (mean ± SD, 6.62% ± 3.87%) was found to be significantly lower than either before (10.62% ± 5.18%) or after coronary angiography (11.66% ± 5.30%; P = 0.007 and P = 0.001, respectively). Basal and postangiographic flow-mediated dilatation values were similar. Flow-mediated dilatation significantly decreased after sheath insertion in the group with angiographically normal coronary arteries (14.47% ± 4.34% vs 5.98 ± 4.00%, respectively; P = 0.006), whereas the difference was not significant in patients with CAD (8.17% ± 4.16% vs 7.03% ± 3.92%, respectively).
Conclusions:
Coronary angiography did not result in endothelial vasomotor dysfunction. Femoral arterial sheath insertion during coronary angiography was associated with a short-lived endothelial dysfunction. Larger studies are needed to interpret the effect of coronary atherosclerosis on attenuation of endothelial response against arterial wall injury.
Related Concept Videos
01:19Imaging Studies VII: Vascular Imaging
01:28Cardiac Catheterization I: Pre-Procedure Overview
01:27Coronary Artery Disease V: Interprofessional Care
01:24Cardiac Catheterization III: Left Heart Catheterization