open access

Vol 23, No 1 (2016)
Original articles
Published online: 2015-09-23
Get Citation

Incidence and predictors of radial artery injury following transradial procedures: Yet another benefit of renin–angiotensin system blockade?

Burak Turan, Ayhan Erkol, Fatih Yılmaz, Mehmet Mustafa Can, İsmail Erden
DOI: 10.5603/CJ.a2015.0057
·
Pubmed: 26412611
·
Cardiol J 2016;23(1):64-70.

open access

Vol 23, No 1 (2016)
Original articles
Published online: 2015-09-23

Abstract

Background: Vasodilatory function of radial artery (RA) declines following the transradial catheterization. However, it is uncertain whether impaired vasodilatory function develops in every patient. The aim of this study was to investigate the incidence and predictive factors of impaired vasodilatory function following transradial procedures.

Methods: Consecutive patients undergoing elective transradial procedures were prospectively enrolled. Ultrasound examination of RA was recorded just before and 1 week after the procedure. RA diameters and flow velocities were measured at baseline, after flow mediated vasodilation (FMD) and after nitrate mediated vasodilation (NMD).

Results: Fifty-one patients were included (62 ± 11 years, 55% male, 41% hypertensive, 20% diabetic, 65% with coronary artery disease). Overall FMD and NMD were significantly impaired after 1 week. However, deterioration of FMD and NMD was observed in 67% and 71% of patients, respectively. Absolute change in FMD was significantly different in patients using a renin– angiotensin system (RAS) inhibitor compared to those who were not (1.9 ± 12.9 vs. –7.7 ± ± 12.7%, respectively, p = 0.025). Additionally, there was a moderate but significant correlation between baseline RA diameter and absolute change in NMD (r = 0.419, p < 0.001). RAS blockade was independently associated with protection against FMD deterioration (OR 0.241, 95% CI 0.066–0.883, p = 0.032), whereas RA diameter (OR 0.079, 95% CI 0.009–0.720, p = 0.024) and procedure time (OR 1.156, 95% CI 0.989–1.350, p = 0.068) were associated with NMD deterioration, although the latter had borderline significance.

Conclusions: Vasodilatory function of RA gets impaired in most patients following transradial procedures. RAS blockade seems to exert a protective role against deteriorating endothelium- dependent vasodilation, whereas smaller RA diameter and potentially longer procedure time are associated with impaired endothelium-independent vasodilation.  

Abstract

Background: Vasodilatory function of radial artery (RA) declines following the transradial catheterization. However, it is uncertain whether impaired vasodilatory function develops in every patient. The aim of this study was to investigate the incidence and predictive factors of impaired vasodilatory function following transradial procedures.

Methods: Consecutive patients undergoing elective transradial procedures were prospectively enrolled. Ultrasound examination of RA was recorded just before and 1 week after the procedure. RA diameters and flow velocities were measured at baseline, after flow mediated vasodilation (FMD) and after nitrate mediated vasodilation (NMD).

Results: Fifty-one patients were included (62 ± 11 years, 55% male, 41% hypertensive, 20% diabetic, 65% with coronary artery disease). Overall FMD and NMD were significantly impaired after 1 week. However, deterioration of FMD and NMD was observed in 67% and 71% of patients, respectively. Absolute change in FMD was significantly different in patients using a renin– angiotensin system (RAS) inhibitor compared to those who were not (1.9 ± 12.9 vs. –7.7 ± ± 12.7%, respectively, p = 0.025). Additionally, there was a moderate but significant correlation between baseline RA diameter and absolute change in NMD (r = 0.419, p < 0.001). RAS blockade was independently associated with protection against FMD deterioration (OR 0.241, 95% CI 0.066–0.883, p = 0.032), whereas RA diameter (OR 0.079, 95% CI 0.009–0.720, p = 0.024) and procedure time (OR 1.156, 95% CI 0.989–1.350, p = 0.068) were associated with NMD deterioration, although the latter had borderline significance.

Conclusions: Vasodilatory function of RA gets impaired in most patients following transradial procedures. RAS blockade seems to exert a protective role against deteriorating endothelium- dependent vasodilation, whereas smaller RA diameter and potentially longer procedure time are associated with impaired endothelium-independent vasodilation.  

Get Citation

Keywords

radial artery, catheterization, endothelium, vasodilation, renin–angiotensin system

About this article
Title

Incidence and predictors of radial artery injury following transradial procedures: Yet another benefit of renin–angiotensin system blockade?

Journal

Cardiology Journal

Issue

Vol 23, No 1 (2016)

Pages

64-70

Published online

2015-09-23

DOI

10.5603/CJ.a2015.0057

Pubmed

26412611

Bibliographic record

Cardiol J 2016;23(1):64-70.

Keywords

radial artery
catheterization
endothelium
vasodilation
renin–angiotensin system

Authors

Burak Turan
Ayhan Erkol
Fatih Yılmaz
Mehmet Mustafa Can
İsmail Erden

Important: This website uses cookies. More >>

The cookies allow us to identify your computer and find out details about your last visit. They remembering whether you've visited the site before, so that you remain logged in - or to help us work out how many new website visitors we get each month. Most internet browsers accept cookies automatically, but you can change the settings of your browser to erase cookies or prevent automatic acceptance if you prefer.

By "Via Medica sp. z o.o." sp.k., ul. Świętokrzyska 73, 80–180 Gdańsk, Poland
tel.:+48 58 320 94 94, fax:+48 58 320 94 60, e-mail: viamedica@viamedica.pl