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February 19, 2003Catheterization and Cardiovascular Interventions

Evaluation of a spasmolytic cocktail to prevent radial artery spasm during coronary procedures

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Why the study?

Does an intra-arterial vasodilating cocktail reduce the incidence and severity of radial artery spasm in patients undergoing coronary procedures via the radial artery?

Population

100 patients undergoing coronary procedures via the radial artery

Comparison

Intra-arterial cocktail prior to sheath insertion vs No vasodilating drug

Design

Cohort

Follow-up

At the end of the procedure (sheath removal)

Key result

An intra-arterial vasodilating cocktail of verapamil and nitroglycerine significantly reduced the incidence of pain during sheath removal compared to no vasodilating drug (14% vs 34%; P=0.019).

Authors

FKFerdinand KiemeneijBVBhavesh VajifdarSESimon Eccleshall

Discussion

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Overview

May reduce sheath removal pain in transradial access; leaves open whether vasodilator cocktails prevent radial spasm in randomized trials.

Study Design

Type

RCT (n=100)

Structured PICO

Does an intra-arterial vasodilating cocktail reduce the incidence and severity of radial artery spasm in patients undergoing coronary procedures via the radial artery?

P
Population
100 patients undergoing coronary procedures via the radial artery.
I
Intervention
Intra-arterial cocktail (5 mg of verapamil plus 200 micro g nitroglycerine in 10 ml of normal saline) prior to sheath insertion
C
Comparator
No vasodilating drug
O
Outcome
Incidence and severity of radial artery spasm (assessed by pain score and maximal pullback force during automatic sheath removal)surrogate

Main Result

Absolute Event Rate: 14% vs 34%

p-value: p=0.019

Administration of an intra-arterial cocktail of verapamil and nitroglycerine prior to sheath insertion significantly reduces the occurrence and severity of radial artery spasm during transradial coronary procedures.

Cite This Study

Kiemeneij et al. (2003) conducted an RCT in Radial artery spasm during coronary procedures (n=100). Intra-arterial vasodilating cocktail (verapamil and nitroglycerine) vs. No vasodilating drug was evaluated on Pain (pain score of III-V) during automatic sheath removal (p=0.019). An intra-arterial vasodilating cocktail of verapamil and nitroglycerine significantly reduced the incidence of pain during sheath removal compared to no vasodilating drug (14% vs 34%; P=0.019).

synapsesocial.com/papers/6aa6858cbc2c7db7488e661ehttps://doi.org/10.1002/ccd.10445
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Also Consider

Synapse has enriched 2 closely related papers on similar clinical questions. Consider them for comparative context:

  1. 1Percutaneous radial artery approach for coronary angiography1989 · 896 citations
  2. 2Measurement of radial artery spasm using an automatic pullback device2001 · 49 citations