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Transdermal Nitroglycerin Patch as a Potential Pretreatment to Prevent Radial Artery Spasm During Transradial Cardiac
Kota Murai, Masashi Fujino, Yu Kataoka
1Department of Cardiovascular Medicine, National Cerebral & Cardiovascular Center, 6-1, Kishibe-Shimmachi, Suita, Osaka, 564-8565, Japan. fujinom@ncvc.go.jp.
Insights
Nitroglycerin patches may prevent radial artery vasospasm during transradial coronary catheterization. This approach can improve procedural success rates, particularly for patients with a history of vasospasm.
Area of Science:
- Interventional Cardiology
- Vascular Medicine
- Pharmacology
Background:
- Radial artery access is recommended for coronary catheterization due to reduced complications.
- The transradial approach can be challenging due to small vessel size and vasospasm.
- Previous studies suggest nitroglycerin injection can dilate the radial artery.
Purpose of the Study:
- To evaluate the efficacy of a nitroglycerin transdermal patch in preventing radial artery vasospasm.
- To assess the potential of the transdermal patch to improve transradial approach success rates.
Main Methods:
- A case study exploring the application of a nitroglycerin transdermal patch.
- Utilizing local transdermal absorption for vasospasm prevention.
- Monitoring for vasospasm during radial artery catheterization.
Main Results:
- The nitroglycerin transdermal patch demonstrated applicability in preventing vasospasm.
- Local transdermal absorption facilitated arterial wall effects.
- Potential for improved success rates in transradial procedures was suggested.
Conclusions:
- Nitroglycerin transdermal patches may be a viable method to prevent radial artery vasospasm.
- This approach could enhance the success of the transradial approach, especially in susceptible patients.
- Further investigation into transdermal nitroglycerin for radial artery access is warranted.
Abstract:
A recent guideline has recommended the radial artery as the access site for coronary catheterization due to lower risk of bleeding and vascular complications. However, the transradial approach is not necessarily easy for interventionalists due to the smaller vessel diameter and more frequent occurrence of vasospasm induced by the procedure. By using the measurement in ultrasound, a previous study demonstrated that subcutaneous nitroglycerin injection at the radial artery puncture site dilated the radial artery, and that a patch was also easier and less invasive. The current case suggests the applicability of a nitroglycerin transdermal patch to prevent vasospasm via local transdermal absorption into the arterial wall; its use may lead to a higher success rate for the transradial approach, especially in patients who had experienced radial artery vasospasm.
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