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Balloon-Assisted Tracking to Overcome Radial Spasm during Transradial Coronary Angiography: A Case Report
1Department of Cardiology, B2-137, Academic Medical Center-UvA, Meibergdreef 9, 1105 AZ Amsterdam, The Netherlands.
Insights
Severe radial artery spasm can impede transradial coronary angiography. A novel technique effectively managed spasm in a patient with aortic stenosis, enabling successful angiography.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Access
Background:
- Radial artery spasm is a primary cause of transradial coronary angiography failure.
- Standard spasmolytic cocktails are contraindicated in patients with aortic stenosis or reduced left ventricular function.
Purpose of the Study:
- To describe a technique for managing severe radial artery spasm during transradial coronary angiography.
- To present a case in a patient with moderate aortic valve stenosis.
Main Methods:
- A case report detailing the application of a recently published technique.
- Transradial coronary angiography performed in a patient with moderate aortic valve stenosis and severe radial spasm.
Main Results:
- The described technique successfully overcame severe radial artery spasm.
- The transradial coronary angiography was successfully completed despite patient comorbidities.
Conclusions:
- This technique offers a viable solution for radial artery spasm in high-risk patients.
- It expands the utility of transradial approach in patients with contraindications to standard spasmolytic agents.
Abstract:
Spasm of the radial artery is the most important cause of failure to perform coronary angiography via the transradial approach. Spasmolytic cocktail may prevent radial artery spasm but is relatively contraindicated in patients with aortic stenosis or diminished left ventricular function. In this case report we describe a recently published technique to overcome severe radial spasm during transradial coronary angiography in a patient with moderate aortic valve stenosis.
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01:11Assessment of radial pulse
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01:25Assessment of apical radial pulse
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation