Flow-mediated dilatation facilitates transradial coronary angiography: a comparative study

Radial artery (RA) spasm is demonstrated to be one of the most common complications of transradial approach (TRA).

We hypothesised that radial flow-mediated dilation (FMD) can be used as a preprocedural method to assess the likelihood of arterial spasm.

The patients were divided into 2 groups: those with and without flow-mediated RA dilatation. A blood pressure cuff was placed on the upper part of the antecubital region of the patients in the FMD group and inflated for 10 min, allowing the pressure to rise to 30 mm Hg above the systolic blood pressure. RA diameters of the patients in both groups were measured via quantitive coronary angiography method before transradial coronary angiography.

A total of 165 patients were included in the study, of whom 64 (38.8%) were women. The median age of the patients was 56 years (48-63). The mean RA diameter was significantly larger in the FMD group (3.44 ±0.48 vs. 2.96 ±0.46 mm, p < 0.001), and the number of punctures required for successful transradial cannulation was found to be significantly higher in the group without FMD (1.55 ±0.7 vs. 1.20 ±0.64; p < 0.001). Linear regression analysis revealed diabetes and FMD as independent predictors of RA diameter. In the diabetic subgroup, RA diameter remained larger in the FMD group (3.00 ±0.35 vs. 2.78 ±0.26, p = 0.036). Radial puncture attempts were significantly higher in the control group compared to the FMD group (1.55 ±0.7 vs. 1.20 ±0.64; p < 0.001).

In our study, we demonstrated that FMD created by pressure application significantly increased RA diameter and reduced puncture attempt during TRA.