Prevention of arterial spasm during percutaneous coronary interventions through radial artery: The SPASM study
Why the study?
Does the administration of vasodilators (molsidomine, verapamil, or their combination) prevent radial artery spasm in patients undergoing transradial percutaneous coronary interventions?
Population
1,219 patients undergoing percutaneous coronary interventions through the radial artery
Comparison
Vasodilators administered through the arterial… vs Placebo administered through the arterial sheath
Design
RCT, consecutively randomized
Authors
Discussion
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Implication
Combination verapamil-molsidomine via sheath minimizes radial spasm risk; extends RCT evidence for optimized dual-vasodilator regimens in transradial PCI.
Key Points
- Evaluate the efficacy of vasodilators to prevent radial artery spasm during percutaneous coronary interventions.
- 1,219 patients randomized to receive placebo or vasodilators (verapamil, molsidomine) through arterial sheath.
- Drug dosages included molsidomine 1 mg, verapamil 2.5 mg, verapamil 5 mg, and a combination of both.
- Primary endpoint defined as the occurrence of radial artery spasm by operator assessment.
- Radial artery spasm occurred in 22.2% of placebo, 13.3% for molsidomine 1 mg, 8.3% for verapamil 2.5 mg, 7.9% for verapamil 5 mg, and 4.9% for combined verapamil and molsidomine (P<0.0001).
- Combined verapamil 2.5 mg and molsidomine 1 mg provided the strongest reduction in spasm rates compared to placebo.
- Vasodilators significantly reduce the occurrence of spasm during transradial interventions.
Structured PICO
Does the administration of vasodilators (molsidomine, verapamil, or their combination) prevent radial artery spasm in patients undergoing transradial percutaneous coronary interventions?
P
Population
1,219 patients undergoing percutaneous coronary interventions through the radial artery
I
Intervention
Vasodilators administered through the arterial sheath: molsidomine 1 mg, verapamil 2.5 mg, verapamil 5 mg, or a combination of verapamil 2.5 mg and molsidomine 1 mg
C
Comparator
Placebo administered through the arterial sheath
O
Outcome
Occurrence of a radial artery spasm defined by the operator as severe limitation of the catheter movement, with or without angiographic confirmationsafety
The combination of verapamil 2.5 mg and molsidomine 1 mg administered through the arterial sheath significantly reduces the risk of radial artery spasm during transradial percutaneous coronary interventions compared to placebo or monotherapy.
Cite This Study
Varenne et al. (2006) studied this question.