Key result
Multiple puncture attempts are linked to ~2.6-fold higher odds of radial artery spasm during transradial procedures.
Why the study?
Radial artery spasm remains a frequent complication during transradial coronary procedures that limits equipment manipulation and causes patient discomfort, motivating a synthesis of its clinical, anatomical, and procedural risk factors.
What clinical, anatomical, and procedural risk factors increase the incidence of radial artery spasm in patients undergoing transradial coronary procedures?
Meta-Analysis
What clinical, anatomical, and procedural risk factors increase the incidence of radial artery spasm in patients undergoing transradial coronary procedures?
Identifies simple, non-invasive clinical and anatomical markers (such as female sex, shorter stature, and small wrist circumference) to pre-procedurally screen patients at high risk for radial artery spasm, enabling targeted use of hydrophilic sheaths, sedation, or ultra-thin devices.
Answers are grounded in this paper and cite their sources.
Supports pre-procedural risk stratification to reduce spasm during transradial access; leaves open whether targeted interventions improve outcomes in prospective trials.
Background: Transradial access is now the standard approach to do coronary procedures because it is so safe. Radial artery spasm (RAS) remains a frequent complication that limits equipment manipulation and causes patient discomfort. Objective: This study evaluates the clinical, anatomical, and procedural risk factors associated with RAS.. Methods: In accordance with PRISMA guidelines, a systematic literature search was conducted across databases until March 2, 2026. Studies examining risk factors for radial artery spasm during coronary procedures were included. A random-effects model was used for our meta-analysis. Result: A total of 20 studies met the inclusion criteria and were included in the quantitative meta-analysis. Among patient-related factors, female sex (OR 2.51), shorter height (MD -3.82), lower weight (MD -3.34), smaller wrist circumference (MD -0.55), and a narrower radial artery diameter (MD -0.27) were significantly associated with increased risk of RAS. Multiple puncture attempts (OR 2.59), longer procedure durations (MD 7.83), and angioplasty procedures (OR 1.30) increased the risk of spasm. Whereas right puncture site (OR 0.59) and diagnostic-only angiograms (OR 0.71) showed a lower incidence. Conclusion: In conclusion, radial artery spasm is predominantly driven by mechanical trauma and anatomical mismatch. Some non-invasive signs that can be used to find people who are at high risk are being female, being shorter, and having a small wrist size. This lowers the chance of access site problems, gives a true clinical base for screening, and lets hydrophilic sheaths, the right kind of sedation, or ultra-thin devices be used in the right places.
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Sahara et al. (2026) conducted a meta-analysis in Transradial coronary procedures (coronary angiography and percutaneous coronary intervention). Clinical, anatomical, and procedural risk factors (e.g., female sex, multiple puncture attempts) vs. Absence of risk factors or reference groups (e.g., male sex, single puncture attempt, right puncture site) was evaluated on Radial artery spasm (RAS) (OR 2.59). Female sex (OR 2.51), multiple puncture attempts (OR 2.59), and smaller radial diameter (MD -0.27) significantly increased radial artery spasm risk during transradial coronary procedures.
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