Can radial artery pulse grading predict radial artery spasm during transradial approach?

Abstract

Background: Radial artery spasm (RAS) has been defined as one of the major disadvantage of transradial approach.

Aim: The aim of this study was to investigate the predictive value of radial artery pulse grading on RAS during transradial approach.

Methods: The present study prospectively included 115 consecutive patients who underwent transradial coronary catheterisation at a single centre. Patients were divided into two groups: those with RAS and those without.

Results: The incidence of RAS was 16.5% (n = 19). Multivariate logistic regression analysis demonstrated that female sex, guiding catheter usage, and radial artery pulse grading ≤ 2 independently predicted RAS (odds ratio [OR] 8, 95% confidence interval [CI] 1.8–36.2, p = 0.007, OR 10.6, 95% CI 2.2–51.2, p = 0.03 and OR 25.8, 95% CI 6.1–108.5, p < 0.001, respec­tively). These three variables were weighted proportionally to their respective OR for RAS (female sex [1.5 points], guiding catheter usage [2 points], and radial artery pulse grading ≤ 2 [5 points]). Two risk strata were defined (low risk, score 0–4, high risk, score 5–8.5), and high risk was associated with increased incidence of RAS (n = 13 [61.9%] vs. n = 6 [6.4%], p < 0.001).

Conclusions: Radial artery pulse grading together with female sex and guiding catheter usage are independent predictors of RAS, and by using a simple risk score high-risk patients for RAS can be identified.