FREQUENCY AND PREDICTORS OF RADIAL ARTERY SPASM DURING CORONARY ANGIOGRAPHY/PERCUTANEOUS CORONARY INTERVENTION

Authors

  • Matiullah khan Ayub teaching hospital
  • Muhammad Yousuf daud
  • Muhammad Saleem Awan
  • Muhammad Imran Khan
  • Hazratullah Khan
  • Muhammad Awais Yousuf MO,AIMC Abbottabad

Abstract

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 effecting 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. Conclusion: 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.

Keywords: Coronary angiography; PCI; Radial artery spasm

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 effecting 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. Conclusion: 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.

Keywords: Coronary angiography; PCI; Radial artery spasm

Author Biographies

Matiullah khan, Ayub teaching hospital

Assistant Professor,cardiology department

Muhammad Yousuf daud

Consultant Cardiologist,cardiology department

Muhammad Saleem Awan

Assistant Professor,cardiology department

Muhammad Imran Khan

Assistant Professor,cardiology department

Hazratullah Khan

Assistant Professor,cardiology department

References

Cooper CJ, El-Shiekh RA, Cohen DJ, Blaesing L, Burket MW, Basu A, et al. Effect of transradial access on quality of life and cost of cardiac catheterization: A randomized comparison. Am Heart J 1999;138(3 Pt 1):430-6.

Mann T, Cubeddu G, Bowen J, Schneider JE, Arrowood M, Newman WN, et al. Stenting in acute coronary syndromes: A comparison of radial versus femoral access sites. J Am Coll Cardiol 1998;32(3):572-6.

Kiemeneij F, Hofland J, Laarman GJ, van der Elst DH, van der Lubbe H. Cost comparison between two modes of Palmaz Schatz coronary stent implantation: Transradial bare stent technique vs. transfemoral sheath-protected stent technique. Cathet Cardiovasc Diagn 1995;35(4):301-8.

Choussat R, Black A, Bossi I, Fajadet J, Marco J. Vascular complications and clinical outcome after coronary angioplasty with platelet IIb/IIIa receptor blockade. Comparison of transradial vs transfemoral arterial access. Eur Heart J 2000;21(8):662-7.

Caputo RP, Tremmel JA, Rao S, Gilchrist IC, Pyne C, Pancholy S, et al. Transra-dial arterial access for coronary and peripheral procedures: Executive summary by the Transradial Committee of the SCAI. Catheter Cardiovasc Interv 2011;78(6):823-39.

Hamon M, Pristipinoc, Di Mario C, Nolan J, Ludwig J, Tubaro M, et al. Con-sensus document on the radial approach in percutaneous cardiovascular interventions: Position paper by the Euro-pean Association of Percutaneous Cardiovascular Inter-ventions and Working Groups on Acute Cardiac Care and Thrombosis of the European Society of Cardiology. Eurointervention 2013;8(11):1242-51.

Gorgulu S, Norgaz T, Karaahmet T, Dagdelen S. Incidence and predictors of radial artery spasm at the beginning of a transradial coronary procedure. J Interv Cardiol 2013;26(2):208-13.

He GW, Yang CQ. Comparison among arterial grafts and coronary artery. An attempt at functional clas-sification. J Thorac Cardiovasc Surg 1995;109(4):707-15.

Kiemeneij F, Laarman GJ, Odekerken D, Slagboom T, van der Wieken R. A randomized comparison of percutaneous transluminal coronary angioplasty by the radial, brachial and femoral approaches: the access study. J Am Coll Cardiol 1997;29(6):1269-75.

Goldberg SL, Renslo R, Sinow R, French WJ. Learning curve in the use of the radial artery as vascular access in the performance of percutaneous transluminal coronary angioplasty. Cathet Cardiovasc Diagn 1998;44(2):147-52.

Kiemeneij F, Vajifdar BU, Eccleshall SC, Laarman G, Slagboom T, Wieken RV. Evaluation of a spasmolytic cocktail to prevent radial artery spasm during coronary procedures. Cathet Cardiovasc Intervent 2003;58(3):281-4.

Chardigny C, Jebra VA, Acar C, Descombes JJ, Verbeuren TJ, Carpentier A, et al. Vasoreactivity of the radial artery. Comparison with the internal mammary and gastroepiploic arteries with implications for coronary artery surgery. Circulation 1993;88(5 Pt 2):II115-27.

Kotowycz MA, Džavík V. Radial artery patency after transradial catherization Circulation. Cardiovasc Interven 2012;5(1):127-33.

Jia DA, Zhou YJ, Shi DM, Liu YY, Wang JL, Liu XL, et al. Incidence and predictors of radial artery spasm during transradial coronary angiography and intervention. China J Med 2010;123(7):843-7.

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Published

2020-06-16

How to Cite

khan, M., daud, M. Y., Awan, M. S., Khan, M. I., Khan, H., & Yousuf, M. A. (2020). FREQUENCY AND PREDICTORS OF RADIAL ARTERY SPASM DURING CORONARY ANGIOGRAPHY/PERCUTANEOUS CORONARY INTERVENTION. Journal of Ayub Medical College Abbottabad, 32(3), 356–358. Retrieved from https://www.jamc.ayubmed.edu.pk/jamc/index.php/jamc/article/view/7643

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