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Use of the Sheathless Eaucath Is an Effective Strategy to Overcome Resistant Severe Radial Spasm

Andrew Borrie1, Aditya Raina1, Sarah Fairley1

  • 1Wellington Hospital, Wellington, New Zealand.

Journal of Interventional Cardiology
|March 6, 2023
PubMed

Insights

The sheathless Eaucath guiding catheter (SEGC) effectively resolves severe radial artery spasm during coronary angiography when conventional methods fail. This approach offers a safe and successful alternative to transfemoral access, improving procedural outcomes.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Access

Background:

  • Radial artery spasm is a common complication during transradial access (TRA).
  • Managing severe radial spasm can be challenging, potentially leading to procedural delays or conversion to alternative access routes.
  • Effective strategies are needed to overcome this limitation in TRA procedures.

Purpose of the Study:

  • To evaluate the efficacy and safety of the sheathless Eaucath guiding catheter (SEGC) in managing severe radial artery spasm.
  • To determine if SEGC can facilitate successful coronary artery engagement in cases of resistant spasm.
  • To assess the impact of SEGC use on the need for transfemoral access (TFA) conversion.

Main Methods:

  • A prospective observational study involving 1000 patients undergoing coronary angiography.
  • Patients with severe radial spasm unresponsive to conventional treatment (sedation, vasodilators) were considered for SEGC use.
  • The primary endpoint was successful passage of the SEGC and engagement of the coronary artery.

Main Results:

  • Out of 898 patients with radial access, 49 (5.5%) developed severe spasm.
  • After initial treatment, spasm persisted in 44 patients, who then received the SEGC.
  • The SEGC successfully navigated the spastic radial artery and engaged the coronary arteries in all 44 patients without complications.

Conclusions:

  • The sheathless Eaucath guiding catheter is highly effective for treating resistant severe radial artery spasm.
  • SEGC offers a safe and successful solution, potentially reducing the need for conversion to transfemoral access.
  • This technique enhances the utility of transradial access in challenging anatomical situations.
Abstract

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