We investigated prevalence and predictors of radial artery spasm (RAS) associated
with transradial approach (TRA) during coronary angiography & angioplasty.
Methods and results:
The study is a cross sectional study, conducted at cardiac catheterization unit at Benha University Hospital. This study included one hundred patients whom were suitable for transradial approach either coronary angiography or percutanous coronary intervention. The administration of medication to prevent spasm (premedications) were left for operators discretion. RAS was defined according to severity of symptoms into 5 grades. Primary procedural success was defined as completion of the intended procedure via the initial access site. Secondary procedural success was defined as completion via contralateral radial artery.
The mean age of the study group was 57.1 ±11.2 years, 33% were female, RAS occurred in 22% of the study population. However technical success in TRA was 98%, despite occurrence of RAS.
There was no difference at baseline clinical characteristics of between spasm and no spasm group. Technically there was no statistically significant difference regarding performance of Allen's test prior to procedure, Also there is no difference were observed with use of spasmolytic cocktail and use of right versus left radial access.
The only predictors for RAS at multivariate analysis were number of attempts of radial puncture (p=0.03), sheath size (p=0.001) & catheter size (p=0.01).
Radial approach is safe and effective route for coronary angiography and intervention, with beneficial value of decrease access site bleeding, together with patient's comfort and early mobilization. Despite occurrence of RAS during TRA, it did not preclude successful procedure.