Vol 25, No 1 (2018)
Original articles — Interventional cardiology
Published online: 2017-10-18

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Flow-mediated dilatation to relieve puncture-induced radial artery spasm: A pilot study

Lianghong Ying12, Ke Xu1, Xiaoxuan Gong3, Xiaoyan Liu2, Yuansheng Fan1, Haiping Zhao2, Fei Wang1, Mohammad Reeaze Khurwolah1, Chunjian Li1
Pubmed: 29064536
Cardiol J 2018;25(1):1-6.

Abstract

Background: Puncture-induced radial artery spasm (RAS) may extend the duration of coronary an­giography (CAG) or cause transradial access failure. Flow-mediated dilatation (FMD), a widely-used noninvasive approach for assessing endothelial function, was reported to remove the entrapped radial sheath after percutaneous coronary intervention. Herein, the efficacy and safety of FMD in treating puncture-induced RAS before transradial CAG was investigated.

Methods: Ninety patients with puncture-induced RAS were randomized in a 1:1:1 ratio into three groups: FMD group was immediately treated with blockage of brachial artery blood for 5 min using a sphygmomanometric cuff and then rapid relief; nitroglycerin (NTG) group was administered with 0.5 mg sublingual NTG instantly; and the no-therapy group was treated with a wait-and-watch strategy. The time of radial pulse recovery, and regional and systemic complications were recorded.

Results: The rate of radial pulse recovery within 30 min in FMD group was significantly higher than that in no-therapy group (97% vs. 73%, p = 0.026). The median time to return of radial pulse in FMD group and NTG group was significantly shorter than that in no-therapy group (7 [6.5–9] min vs. 15 [12–18] min, 8 [7–9] min vs. 15 [12–18] min, respectively; both p < 0.001). Headache and decreased blood pressure were more prevalent in NTG group than those in FMD and no-therapy groups.

Conclusions: FMD is a feasible, noninvasive and nonpharmacological approach to relieve RAS and facilitate radial artery cannulation after an initial failed attempt. (Cardiol J 2018; 25, 1: 1–6)

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