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Frequency And Predictors Of Radial Artery Spasm During Coronary Angiography/Percutaneous Coronary Intervention
Matiullah Khan1, Muhammad Yousuf Daud1, Muhammad Saleem Awan1
1Department of Cardiology, Ayub Teaching Hospital, Abbottabad, Pakistan.
Insights
Radial artery spasm occurs in 13.24% of patients undergoing coronary angiography via the trans-radial approach. This complication is more common in females and associated with difficult arterial access.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Access
Background:
- Coronary angiography is the gold standard for diagnosing coronary artery disease.
- Trans-radial access offers benefits like reduced complications and early mobilization but can cause radial artery spasm.
- Radial artery spasm is a significant procedural complication.
Purpose of the Study:
- To determine the frequency of radial artery spasm during trans-radial coronary angiography.
- To identify predictors of radial artery spasm in patients undergoing the procedure.
Main Methods:
- A descriptive cross-sectional study of 136 patients undergoing coronary angiography/PCI via trans-radial approach.
- Patients were monitored for radial artery spasm using clinical and angiographic parameters.
- Data analysis was performed using SPSS-19.
Main Results:
- The overall frequency of radial artery spasm was 13.24%.
- Radial artery spasm was significantly associated with female gender, severe pain during puncture, and unsuccessful first puncture attempts.
- No significant association was found with age, hypertension, or diabetes mellitus.
Conclusions:
- Radial artery spasm is a common complication in trans-radial coronary angiography.
- Female patients, those experiencing severe puncture pain, and those with failed initial access attempts are at higher risk.
- Identifying these risk factors can help mitigate spasm during procedures.
Background:
Coronary angiography is the gold standard test for diagnosis coronary artery disease. It can be performed via various intra-arterial routes, i.e., femoral, radial, brachial, ulnar, or axillary arteries. Trans-Radial access for coronary angiography is a good approach with less major vascular complications, increased patient comfort and early mobilization and less hospital stay but is associated with radial artery spasm as the major complication affecting the success of the procedure.
Methods:
This study was a descriptive cross-sectional study. It enrolled one hundred and thirty-six (136) consecutive patients who underwent the procedure of coronary angiography/PCI over a 6-month period. The study included both in and outpatients undergoing coronary angiography/PCI. Coronary angiography/Percutaneous coronary intervention was done via trans radial approach and the study participants were observed for development of radial artery spasm using clinical and angiographic parameters. Data was entered and analysed using SPSS-19.
Results:
The frequency of radial artery spasm was 13.24% (n=18). Radial artery spasm was statistically significant in females (p<0.05), those who had severe pain during radial artery puncture (p<0.001) and those who had unsuccessful first attempt during radial artery puncture (p<0.001). No statistically significant association was found between radial artery spasm and other predictors such as age, hypertension and diabetes mellitus.
Conclusions:
Radial artery spasm is a common complication during trans radial approach for coronary angiography/percutaneous coronary intervention particularly in females, those who have unsuccessful first attempt and those who have severe pain during radial artery puncture.
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