Association of Radial Artery Diameter with Radial Artery Spasm in Patients Undergoing Transradial Cardiac Catheterization

Objective: To assess the association of radial artery spasm (RAS) with radial artery diameter and other factors in patients undergoing transradial cardiac catheterization. Methodology: This descriptive, cross-sectional study was conducted at the Fauji Foundation Hospital, Rawalpindi from June to September 2025 after ethical approval. After taking informed written consent, 150 patients who underwent coronary angiography or percutaneous coronary intervention using transradial approach were included. Prior to the procedure, radial artery diameter was assessed by the linear probe of Xario 100g Ultrasound machine. Radial artery spasm was assessed clinically by the operator and radial artery angiograms. Patients were divided into two groups: group I with no RAS and group II with RAS. The association of RAS with the radial artery diameter and other variables were determined. Statistical Package for the Social Sciences (SPSS) version 26 was used for data analysis. Results: Radial artery spasm occurred in 35(23.3%) patients. The time to vascular access was significantly higher (150.60±49.77 seconds) in patients with RAS as compared to those without spasm (43.69±29.61 seconds) (p=0.001). The number of procedure attempts, episodes of vasovagal syncope (3.3% versus 0%) and access site crossover (6% versus 0%) were also significantly higher in patients with RAS. The radial artery spasm had a significant positive association with radial artery diameter, ejection fraction, angiographic findings, and treatment plan. The ROC curve showed an area under the curve of 0.876, showing the excellent ability of radial artery diameter to predict RAS. Conclusion: Radial artery spasm affects a significant proportion of patients (23.3%) undergoing transradial cardiac catheterization. The radial artery diameter, vascular access time, need for ultrasound assistance to secure vascular assistance, additional vasodilator & glide wire, vasovagal syncope, and access site crossover were significantly higher in patients with RAS.