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Erschienen in: Herz 5/2016

23.11.2015 | Invasive Diagnostik in der Kardiologie | Original Article

Procedural sedation during transradial coronary angiography to prevent spasm

verfasst von: M. A. Astarcioglu, MD, T. Sen, C. Kilit, H. I. Durmus, G. Gozubuyuk, H. Z. Agus, M. Kalcik, S. Karakoyun, M. Yesin, A. Dogan, M. Ozkan

Erschienen in: Herz | Ausgabe 5/2016

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Abstract

Aim

Radial artery spasm is common during transradial procedures and is the most common cause of procedural failure. The objectives of this study were to assess whether the routine administration of sedation at the beginning of transradial coronary angiography with the use of hydrophilic-coated and smaller sheaths/catheters would reduce the incidence of radial artery spasm.

Patients and methods

Patients undergoing transradial coronary angiography were prospectively randomized to receive midazolam during the procedure or no sedative treatment. The primary endpoint was angiographically confirmed radial artery spasm. Stenosis of the radial artery was measured with a computer-assisted quantification method.

Results

In all, 150 patients were randomized into a treatment group and a control group. Spasm occurred in 15 patients of the treatment group (20 %) versus 16 in the control group (21.3 %). There were no differences between the two groups regarding the incidence of spasm and the distribution of spasm severity (p > 0.05). No significant differences were observed between the two groups in terms of 30-day mortality or repeat hospitalization for any cause (p > 0.05).

Conclusion

Routine use of midazolam could not reduce the occurrence of radial artery spasm during transradial coronary angiography.
Literatur
1.
Zurück zum Zitat Louvard Y, Ludwig J, Lefevre T et al (2002) Transradial approach for coronary angioplasty in the setting of acute myocardial infarction: a dual center registry. Catheter Cardiovasc Interv 55:417–421CrossRef Louvard Y, Ludwig J, Lefevre T et al (2002) Transradial approach for coronary angioplasty in the setting of acute myocardial infarction: a dual center registry. Catheter Cardiovasc Interv 55:417–421CrossRef
2.
Zurück zum Zitat Valsecchi O, Museum G, Visalia A et al (2003) Safety, feasibility and efficacy of transradial primary angioplasty in patients with acute myocardial infarction. Ital Heart J 4:329–334PubMed Valsecchi O, Museum G, Visalia A et al (2003) Safety, feasibility and efficacy of transradial primary angioplasty in patients with acute myocardial infarction. Ital Heart J 4:329–334PubMed
3.
Zurück zum Zitat Caputo RP, Simons A, Gianbartolomei A et al (2000) Transradial cardiac catheterisation in elderly patients. Catheter Cardiovasc Interv 51:287–290CrossRefPubMed Caputo RP, Simons A, Gianbartolomei A et al (2000) Transradial cardiac catheterisation in elderly patients. Catheter Cardiovasc Interv 51:287–290CrossRefPubMed
4.
Zurück zum Zitat Hildick-Smith DJ, Walsh JT, Lowe MD, Petch MC (2003) Coronary angiography in the fully anticoagulated patient: the transradial route is successful and safe. Catheter Cardiovasc Interv 58:8–10CrossRefPubMed Hildick-Smith DJ, Walsh JT, Lowe MD, Petch MC (2003) Coronary angiography in the fully anticoagulated patient: the transradial route is successful and safe. Catheter Cardiovasc Interv 58:8–10CrossRefPubMed
5.
Zurück zum Zitat Goldberg SL, Renslo R, Sinow R, French WJ (1998) Learning curve in the use of the radial artery as vascular access in the performance of percutaneous transluminal coronary angioplasty. Cathet Cardiovasc Diagn 44:147–152CrossRefPubMed Goldberg SL, Renslo R, Sinow R, French WJ (1998) Learning curve in the use of the radial artery as vascular access in the performance of percutaneous transluminal coronary angioplasty. Cathet Cardiovasc Diagn 44:147–152CrossRefPubMed
6.
Zurück zum Zitat Hildick-Smith DJR, Lowe MD, Walsh JT, Ludman PF, Stephens NG, Schofi eld PM, Stone DL, Shapiro LM, Petch MC (1998) Coronary angiography from the radial artery—Experience, complications and limitations. Int J Cardiol 64:231–239CrossRefPubMed Hildick-Smith DJR, Lowe MD, Walsh JT, Ludman PF, Stephens NG, Schofi eld PM, Stone DL, Shapiro LM, Petch MC (1998) Coronary angiography from the radial artery—Experience, complications and limitations. Int J Cardiol 64:231–239CrossRefPubMed
7.
Zurück zum Zitat Coppola J, Patel T, Kwan T, Sanghvi K, Srivastava S, Shah S et al (2006) Nitroglycerin, nitroprusside, or both, in preventing radial artery spasm during transradial artery catheterization. J Invasive Cardiol 18(4):155–158PubMed Coppola J, Patel T, Kwan T, Sanghvi K, Srivastava S, Shah S et al (2006) Nitroglycerin, nitroprusside, or both, in preventing radial artery spasm during transradial artery catheterization. J Invasive Cardiol 18(4):155–158PubMed
8.
Zurück zum Zitat Chen CW, Lin CL, Lin TK, Lin CD (2006) A simple and effective regimen for prevention of radial artery spasm during coronary catheterization. Cardiology 105(1):43–47CrossRefPubMed Chen CW, Lin CL, Lin TK, Lin CD (2006) A simple and effective regimen for prevention of radial artery spasm during coronary catheterization. Cardiology 105(1):43–47CrossRefPubMed
9.
Zurück zum Zitat Varenne O, Jegou A, Cohen R, Empana JP, Salengro E, Ohanessian A et al (2006) Prevention of arterial spasm during percutaneous coronary interventions through radial artery: the SPASM study. Catheter Cardiovasc Interv 68(2):231–235CrossRefPubMed Varenne O, Jegou A, Cohen R, Empana JP, Salengro E, Ohanessian A et al (2006) Prevention of arterial spasm during percutaneous coronary interventions through radial artery: the SPASM study. Catheter Cardiovasc Interv 68(2):231–235CrossRefPubMed
10.
Zurück zum Zitat Kim SH, Kim EJ, Cheon WS, Kim MK, Park WJ, Cho GY et al (2007) Comparative study of nicorandil and a spasmolytic cocktail in preventing radial artery spasm during transradial coronary angiography. Int J Cardiol 120(3):325–330CrossRefPubMed Kim SH, Kim EJ, Cheon WS, Kim MK, Park WJ, Cho GY et al (2007) Comparative study of nicorandil and a spasmolytic cocktail in preventing radial artery spasm during transradial coronary angiography. Int J Cardiol 120(3):325–330CrossRefPubMed
11.
Zurück zum Zitat Byrne J, Spence M, Haegeli L, Fretz E, Della Siega A, Williams M et al (2008) Magnesium sulphate during transradial cardiac catheterization: a new use for an old drug? J Invasive Cardiol 20(10):539–542PubMed Byrne J, Spence M, Haegeli L, Fretz E, Della Siega A, Williams M et al (2008) Magnesium sulphate during transradial cardiac catheterization: a new use for an old drug? J Invasive Cardiol 20(10):539–542PubMed
12.
Zurück zum Zitat Bertrand OF, Rao SV, Pancholy S, Jolly SS, Rodés-Cabau J, Larose E et al (2010) Transradial approach for coronary angiography and interventions: results of the first international transradial practice survey. JACC Cardiovasc Interv 3(10):1022–1031CrossRefPubMed Bertrand OF, Rao SV, Pancholy S, Jolly SS, Rodés-Cabau J, Larose E et al (2010) Transradial approach for coronary angiography and interventions: results of the first international transradial practice survey. JACC Cardiovasc Interv 3(10):1022–1031CrossRefPubMed
13.
Zurück zum Zitat Amoroso G, Kiemeneij F (2010) Transradial access for primary percutaneous coronary intervention: the next standard of care? Heart 96(17):1341–1344 (Review)CrossRefPubMed Amoroso G, Kiemeneij F (2010) Transradial access for primary percutaneous coronary intervention: the next standard of care? Heart 96(17):1341–1344 (Review)CrossRefPubMed
14.
Zurück zum Zitat Siudak Z, Zawislak B, Dziewierz A, Rakowski T, Jakala J, Bartus S et al (2010) Transradial approach in patients with ST-elevation myocardial infarction treated with abciximab results in fewer bleeding complications: data from EUROTRANSFER registry. Coron Artery Dis 21(5):292–297CrossRefPubMed Siudak Z, Zawislak B, Dziewierz A, Rakowski T, Jakala J, Bartus S et al (2010) Transradial approach in patients with ST-elevation myocardial infarction treated with abciximab results in fewer bleeding complications: data from EUROTRANSFER registry. Coron Artery Dis 21(5):292–297CrossRefPubMed
15.
Zurück zum Zitat Dery PJ, Simard S, Barbeau GR (2001) Reduction of discomfort at sheath removal during transradial coronary procedures with the use of hydrophilic coated sheath. Catheter Cardiovasc Interv 54:289–294CrossRefPubMed Dery PJ, Simard S, Barbeau GR (2001) Reduction of discomfort at sheath removal during transradial coronary procedures with the use of hydrophilic coated sheath. Catheter Cardiovasc Interv 54:289–294CrossRefPubMed
16.
Zurück zum Zitat Saito S, Tanaka S, Hiroe Y et al (2002) Usefulness of hydrophilic coating on arterial sheath introducer in transradial coronary intervention. Catheter Cardiovasc Interv 56:328–332CrossRefPubMed Saito S, Tanaka S, Hiroe Y et al (2002) Usefulness of hydrophilic coating on arterial sheath introducer in transradial coronary intervention. Catheter Cardiovasc Interv 56:328–332CrossRefPubMed
17.
Zurück zum Zitat Rathore S, Stables RH, Pauriah M, Hakeem A, Mills JD, Palmer ND et al (2010) Impact of length and hydrophilic coating of the introducer sheath on radial artery spasm during transradial coronary intervention: a randomized study. JACC Cardiovasc Interv 3(5):475–483CrossRefPubMed Rathore S, Stables RH, Pauriah M, Hakeem A, Mills JD, Palmer ND et al (2010) Impact of length and hydrophilic coating of the introducer sheath on radial artery spasm during transradial coronary intervention: a randomized study. JACC Cardiovasc Interv 3(5):475–483CrossRefPubMed
18.
Zurück zum Zitat Deftereos S, Giannopoulos G, Raisakis K et al (2013) Moderate procedural sedation and opioid analgesia during transradial coronary interventions to prevent spasm: a prospective randomized study. J Am Coll Cardiol Intv 6:267–273CrossRef Deftereos S, Giannopoulos G, Raisakis K et al (2013) Moderate procedural sedation and opioid analgesia during transradial coronary interventions to prevent spasm: a prospective randomized study. J Am Coll Cardiol Intv 6:267–273CrossRef
19.
Zurück zum Zitat Colussi GL, Di Fabio A, Catena C, Chiuch A, Sechi LA (2011) Involvement of endothelium-dependent and -independent mechanisms in midazolam-induced vasodilation. Hypertens Res 34:929–934CrossRefPubMed Colussi GL, Di Fabio A, Catena C, Chiuch A, Sechi LA (2011) Involvement of endothelium-dependent and -independent mechanisms in midazolam-induced vasodilation. Hypertens Res 34:929–934CrossRefPubMed
20.
Zurück zum Zitat He GW, Yang CQ (1998) Characteristics of adrenoceptors in the human radial artery: clinical implications. J Thorac Cardiovasc Surg 115:1136–1141CrossRefPubMed He GW, Yang CQ (1998) Characteristics of adrenoceptors in the human radial artery: clinical implications. J Thorac Cardiovasc Surg 115:1136–1141CrossRefPubMed
Metadaten
Titel
Procedural sedation during transradial coronary angiography to prevent spasm
verfasst von
M. A. Astarcioglu, MD
T. Sen
C. Kilit
H. I. Durmus
G. Gozubuyuk
H. Z. Agus
M. Kalcik
S. Karakoyun
M. Yesin
A. Dogan
M. Ozkan
Publikationsdatum
23.11.2015
Verlag
Springer Medizin
Erschienen in
Herz / Ausgabe 5/2016
Print ISSN: 0340-9937
Elektronische ISSN: 1615-6692
DOI
https://doi.org/10.1007/s00059-015-4373-5

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