Response of the radial artery to three vasodilatory agents

Abe, Shinya; Meguro, Takeshi; Endoh, Norio; Terashima, Minoru; Mitsuoka, Mikio; Akatsu, Masahiko; Kikuchi, Yasufumi; Takizawa, Kazuyasu

doi:10.1002/(sici)1522-726x(200003)49:3<253::aid-ccd5>3.0.co;2-5

Cited by 28 publications

(19 citation statements)

References 8 publications

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“…[17][18][19] Dentre outros fatores de prevenção, a utilização de várias drogas com efeito vasodilatador tem se mostrado eficaz em vários estudos 7,8,[20][21][22] , além da utilização de introdutores hidrofílicos, que promovem menor reação inflamatória tecidual local por menor trauma mecânico à parede arterial. Em estudo randomizado recente, Rathore et al 14 avaliaram 790 pacientes submetidos a intervenção coronária percutânea que utilizaram introdutores hidrofílicos e não-hidrofílicos e encontraram diminuição de cerca de 50% da incidên-cia de espasmo com a utilização dos introdutores recobertos.…”

Section: Discussionunclassified

Comparação entre um cateter único dedicado e cateteres de Judkins na realização da cineangiocoronariografia pela via radial direita

Tebet¹,

Andrade²,

Andrade³

et al. 2010

Rev. Bras. Cardiol. Invasiva

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RESUMOIntrodução: O espasmo radial é considerado um dos principais fatores de insucesso na via radial. O tempo prolongado de exame, a utilização de cateteres de maior diâme-tro, as fricções do cateter durante a manipulação e o número de cateteres utilizados estão entre as principais causas. A utilização de cateteres únicos dedicados a esse acesso poderia minimizar tais fatores, com consequente diminuição da incidência de espasmo. Método: Registro prospectivo de pacientes consecutivos com suspeita de doença coronária, submetidos a coronariografia pelo acesso radial direito, com introdutores 5 F. (grupo I) foram incluídos e comparados a um grupo controle com mesmo número de pacientes, que utilizaram cateteres de Judkins (grupo II). Houve maior taxa de sucesso do procedimento no grupo I (100% vs. 98%; P = 0,03) e não houve diferença na taxa de sucesso da estratégia escolhida (93,7% vs. 95%; P = 0,59). Houve diminuição estatisticamente significante da duração do procedimento (13,6 + 6 min vs. 15 + 6,4 min; P = 0,007), do tempo de fluoroscopia (2,5 + 1,6 min vs. 3,1 + 2,2 min; P = 0,0009) e do número de cateteres (1,1 + 0,3 vs. 2,1 + 0,6; P < 0,0001) no grupo I. Não houve diferença na ocorrên-cia de espasmo (4,7% vs. 5,7%; P > 0,99). Conclusão: A utilização de cateter dedicado ao acesso radial mostrouse eficaz, segura, com diminuição significativa do tempo de fluoroscopia, do exame e do número de cateteres, com ABSTRACT Comparison of a Single Dedicated Catheter and the Judkins Catheter for Coronary Angiography Using the Right Transradial AccessBackground: Radial spasm is considered one of the main reasons of failure in the transradial approach. The prolonged procedure time, use of large diameter catheters, catheter frictions during manipulation and number of catheters used are among the main causes of radial spasm. The use of catheters dedicated to radial access could minimize such factors, with a consequent reduction in the incidence of spasm. Method: Prospective registry of consecutive patients with suspected coronary artery disease undergoing coronary angiography using the right radial access, with 5 F sheaths. We compared the procedural success, the strategy success, duration of the procedure, fluoroscopy time and the number of catheters used among patients who used the dedicated catheter (Optitorque TM TIG) with those using the Judkins catheter (JL/JR). Results: From September 2009 to July 2010, 300 patients using the dedicated catheter (group I) were included and compared with a control group with the same number of patients whose procedure was performed using Judkins catheters (group II). There was a higher procedure success rate in group I (100% vs. 98%; P = 0.03) and no difference in the chosen strategy success (93.7% vs. 95%; P = 0.59). There was a statistically significant decrease in the duration of the procedure (13.6 + 6 min vs. 15 + 6.4 min; P = 0.007), in fluoroscopy time (2.5 + 1.6 min vs. 3.1 + 2.2 min; P = 0.0009) and number of catheters (1.1 + 0.3 vs. 2.1 + 0.6 min; P < 0.0001) in group I. There...

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Section: Discussionunclassified

Comparação entre um cateter único dedicado e cateteres de Judkins na realização da cineangiocoronariografia pela via radial direita

Tebet¹,

Andrade²,

Andrade³

et al. 2010

Rev. Bras. Cardiol. Invasiva

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“…Abe et al found that ISDN was most potent vasodilator compared to verapamil, lignocaine and placebo [12]. While this study examined multiple doses, it was underpowered across each group.…”

Section: Other Outcomesmentioning

confidence: 95%

“…There are several studies that are significantly underpowered. There were as low as 30 patients in one study [15] and has low as 10 patients in each arm in another study [12]. Furthermore, many of the included studies were not fully published and were only available in abstract form.…”

Section: Accepted M Manuscriptmentioning

confidence: 99%

Intra-arterial vasodilators to prevent radial artery spasm: a systematic review and pooled analysis of clinical studies

Kwok

Rashid

Fraser

et al. 2015

Cardiovascular Revascularization Medicine

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“…Isosorbide dinitrate is more effective than verapamil and lidocaine for radial artery dilatation. 19,20) Severe radial vasospasms occurred in 50% of patients and more frequently involved patients with a small radial artery diameter. We encountered one case with radial artery narrowing during the chronic phase.…”

Section: Vol 45mentioning

confidence: 99%

Vasospasms of the Radial Artery After the Transradial Approach for Coronary Angiography and Angioplasty

et al. 2004

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SUMMARYWe examined vasospasms of the radial artery after a transradial approach was used for coronary angiography or angioplasty. In forty-eight patients (39 males and 9 females), arteriography of the radial artery was initially performed just after the transradial approach was used for coronary angiography and/or angioplasty. Then, five months later, a second arteriography of the radial artery was obtained after a transbrachial approach was used for coronary angiography. First and second arteriographies were compared to evaluate vasospasms of the radial artery. In the present study, more than 75% stenosis in the radial artery, 25-75% stenosis, and less than 25% stenosis were tentatively defined as severe spasms, moderate spasms, and mild spasms, respectively. In arteriographic studies on the radial artery, twenty-four patients (50%) had severe radial artery spasms, eleven patients (23%) had moderate spasms, and thirteen patients (27%) had mild spasms. The diameters of both the proximal and distal radial arteries in the severe spasm group were significantly smaller than those in the mild and moderate spasm groups (proximal site: severe group 2.39 ± 0.70 mm versus mild group 2.98 ± 0.46 mm, P < 0.05, and moderate group 2.96 ± 0.77 mm, P < 0.05, distal site: severe group 2.26 ± 0.60 mm versus mild group 2.73 ± 0.47 mm, P < 0.05, and moderate group 2.86 ± 0.71 mm, P < 0.05). We concluded that vasospasms of the radial artery occurred in most patients after the transradial approach. Furthermore, severe radial spasms were strongly correlated with the size of the diameter of the artery. ( 1,2) Thereafter, both transradial coronary intervention (TRI) and transradial coronary angiography (TRA) have been widely employed in Japan. It has been accepted among cardiologists that the transradial procedure produces fewer vascular complications than the convenFrom the

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Response of the radial artery to three vasodilatory agents

Cited by 28 publications

References 8 publications

Comparação entre um cateter único dedicado e cateteres de Judkins na realização da cineangiocoronariografia pela via radial direita

Comparação entre um cateter único dedicado e cateteres de Judkins na realização da cineangiocoronariografia pela via radial direita

Intra-arterial vasodilators to prevent radial artery spasm: a systematic review and pooled analysis of clinical studies

Vasospasms of the Radial Artery After the Transradial Approach for Coronary Angiography and Angioplasty

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