26287
document
Nitroglycerin , nitroprusside , or both , in preventing radial artery spasm during transradial artery catheterization . OBJECTIVE Radial artery spasm remains a major complication of transradial coronary interventions . The aim of this study was to compare the efficacy of three different intra-arterial vasodilating cocktails in reducing the incidence of radial artery spasm in patients undergoing transradial coronary angiography . The secondary goal was to assess the predictors of arterial spasm in this large group of patients . METHODS A total of 379 patients undergoing the procedure were randomly enrolled in 1 of 3 groups . Every patient in each of the 3 groups received intra-arterial heparin , lidocaine and diltiazem . Along with that , patients in Group A received nitroglycerin ; patients in Group B received nitroprusside instead of nitroglycerin ; and patients in Group C received both nitroglycerin and nitroprusside . A single experienced operator , blinded to the study drug , subjectively determined the presence of spasm . RESULTS Of 379 patients , a total of 44 patients ( 11.6 % ) experienced spasm . The occurrence of spasm was similar , independent of the vasodilator cocktail used ( Group A : 12.2 % , Group B : 13.4 % , Group C : 9.5 % ; p = 0.597 ) . After multivariate analysis , the following variables were found to be independent predictors of spasm : radial artery diameter ( RD ) /height index ( p = 0.005 ) , RD/BSA index ( p = 0.012 ) , and sheath outer diameter ( OD ) /RD index ( p = 0.024 ) . CONCLUSION In this prospective , randomized trial , the addition of a direct nitric oxide donor to nitroglycerin in an antispastic cocktail did not reduce the risk of spasm , and the use of nitroglycerin was found to be as effective as nitroprusside . Also , morphometric and mechanical factors play a significant role in predicting the occurrence of radial spasm . The sex of the patient , presence of diabetes , body surface area and smoking history appeared to play no role in predicting the occurrence of radial spasm .
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Intervention_Pharmacological
Nitroglycerin
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Intervention_Pharmacological
nitroprusside
26290
Intervention_Pharmacological
vasodilating cocktails
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Intervention_Pharmacological
heparin
26292
Intervention_Pharmacological
lidocaine
26293
Intervention_Pharmacological
diltiazem
26294
Intervention_Pharmacological
nitroglycerin
26295
Intervention_Pharmacological
nitroprusside
26296
Intervention_Pharmacological
nitroglycerin
26297
Intervention_Pharmacological
nitroglycerin
26298
Intervention_Pharmacological
nitroprusside
26299
Intervention_Pharmacological
nitric oxide
26300
Intervention_Pharmacological
nitroglycerin
26301
Intervention_Pharmacological
nitroglycerin
26302
Intervention_Pharmacological
nitroprusside
26303
Outcome_Physical
radial artery spasm
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Outcome_Physical
radial artery spasm
26305
Outcome_Physical
predictors of arterial spasm
26306
Outcome_Physical
spasm
26307
Outcome_Physical
spasm
26308
Outcome_Physical
reduce the risk of spasm
26309
Outcome_Other
effective
26310
Outcome_Physical
predicting the occurrence of radial spasm
26311
Outcome_Physical
predicting the occurrence of radial spasm
26312
Participant_Condition
transradial artery catheterization
26313
Participant_Condition
transradial coronary angiography
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Participant_Sample-size
379 patients