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Radial artery spasm during transradial coronary procedures.
1University Hospital Split, Division of Cardiology, Department of Internal Medicine, Split, Croatia. kristicivica@gmail.com
The Journal of Invasive Cardiology
|December 8, 2011
Summary
Radial artery spasm (RAS) affects 14.7% of transradial access (TRA) coronary procedures. Hydrophilic coatings and vasodilators significantly reduce RAS incidence, but optimal prevention strategies require further study.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Access
Background:
- Transradial access (TRA) offers advantages for coronary procedures but is limited by radial artery spasm (RAS).
- RAS remains a significant challenge hindering the widespread adoption of TRA.
- Understanding the prevalence and risk factors of RAS is crucial for improving TRA outcomes.
Purpose of the Study:
- To estimate the prevalence of radial artery spasm (RAS) in patients undergoing transradial coronary procedures.
- To identify potential risk factors associated with RAS.
- To evaluate the effectiveness of preventive measures for RAS.
Main Methods:
- A systematic literature search was conducted to identify relevant studies.
- Nineteen published papers, encompassing 7197 patients, were included in the analysis.
- Data on RAS incidence, risk factors, and preventive strategies were extracted and synthesized.
Main Results:
- The overall reported incidence of RAS was 14.7%.
- RAS incidence varied based on diagnostic criteria, premedication protocols, and sheath/catheter selection.
- Hydrophilic coated sheaths/catheters reduced RAS to 1%; intra-arterial verapamil/nitroglycerin reduced it to 3.8%.
Conclusions:
- Radial artery spasm (RAS) remains a significant complication in transradial access (TRA).
- The use of hydrophilic materials and intra-arterial vasodilators are essential for RAS prevention.
- Further research is needed to establish optimal spasmolytic protocols and validate spasm criteria.
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