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Coronary interventions via radial artery without pre-procedural routine use of spasmolytic agents

INTRODUCTION: Radial access reduces the number of vascular complications. Radial artery spasm (RAS) can be prevented by the use of spasmolytic agents. However, use of these drugs can be possibly limited to certain groups of patients. AIM: To assess the feasibility and safety of coronary angiography...

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Autores principales: Bochenek, Tomasz, Lelek, Michał, Kowal-Kałamajka, Małgorzata, Kusz, Błażej, Szczogiel, Jan, Jaklik, Andrzej, Roleder, Tomasz, Mizia-Stec, Katarzyna
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Termedia Publishing House 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7333200/
https://www.ncbi.nlm.nih.gov/pubmed/32636897
http://dx.doi.org/10.5114/aic.2020.96056
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author Bochenek, Tomasz
Lelek, Michał
Kowal-Kałamajka, Małgorzata
Kusz, Błażej
Szczogiel, Jan
Jaklik, Andrzej
Roleder, Tomasz
Mizia-Stec, Katarzyna
author_facet Bochenek, Tomasz
Lelek, Michał
Kowal-Kałamajka, Małgorzata
Kusz, Błażej
Szczogiel, Jan
Jaklik, Andrzej
Roleder, Tomasz
Mizia-Stec, Katarzyna
author_sort Bochenek, Tomasz
collection PubMed
description INTRODUCTION: Radial access reduces the number of vascular complications. Radial artery spasm (RAS) can be prevented by the use of spasmolytic agents. However, use of these drugs can be possibly limited to certain groups of patients. AIM: To assess the feasibility and safety of coronary angiography and percutaneous coronary interventions through the radial artery without the routine use of spasmolytic agents. MATERIAL AND METHODS: A group of 293 patients (M/F 180/113, mean age: 67 ±10 years) who underwent coronary angiography and interventions through the radial artery approach was studied. Spasmolytic agents were applied in case of RAS. Every patient had ultrasound assessment of the radial artery on the next day to assess its diameter and detect occlusion. RESULTS: RAS was observed in 55 patients (18.8%, M/F 28/27) and radial artery occlusion (RAO) in 47 (16%, M/F: 24/23) cases. RAS was followed by RAO in 17 cases, which constituted 17/55 (30.9%) of all RAS. Two patients had symptomatic occlusion, which required prolonged anticoagulation with complete restoration of patency. The RAS was higher in prolonged procedures (angiography time 32.6 ±12.8 vs. 29 ±13.5 min, p = 0.03; intervention time 40 ±23.5 vs. 26.3 ±25 min, p = 0.0035) and was dependent on time of the local pressure (7.5 ±2.3 vs. 6.5 ±2.8 h, p = 0.03). The RAO increased proportionally to the number of catheters used (p = 0.01) and was dependent on time of the local pressure (8.6 ±3.5 vs. 6.4 ±2.7 h, p < 0.001). CONCLUSIONS: Our study showed that angiography and interventions without routine use of spasmolytic agents were feasible and safe. RAS and RAO are related to independent risk factors and comparable to data from the literature when spasmolytics were used.
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spelling pubmed-73332002020-07-06 Coronary interventions via radial artery without pre-procedural routine use of spasmolytic agents Bochenek, Tomasz Lelek, Michał Kowal-Kałamajka, Małgorzata Kusz, Błażej Szczogiel, Jan Jaklik, Andrzej Roleder, Tomasz Mizia-Stec, Katarzyna Postepy Kardiol Interwencyjnej Original Paper INTRODUCTION: Radial access reduces the number of vascular complications. Radial artery spasm (RAS) can be prevented by the use of spasmolytic agents. However, use of these drugs can be possibly limited to certain groups of patients. AIM: To assess the feasibility and safety of coronary angiography and percutaneous coronary interventions through the radial artery without the routine use of spasmolytic agents. MATERIAL AND METHODS: A group of 293 patients (M/F 180/113, mean age: 67 ±10 years) who underwent coronary angiography and interventions through the radial artery approach was studied. Spasmolytic agents were applied in case of RAS. Every patient had ultrasound assessment of the radial artery on the next day to assess its diameter and detect occlusion. RESULTS: RAS was observed in 55 patients (18.8%, M/F 28/27) and radial artery occlusion (RAO) in 47 (16%, M/F: 24/23) cases. RAS was followed by RAO in 17 cases, which constituted 17/55 (30.9%) of all RAS. Two patients had symptomatic occlusion, which required prolonged anticoagulation with complete restoration of patency. The RAS was higher in prolonged procedures (angiography time 32.6 ±12.8 vs. 29 ±13.5 min, p = 0.03; intervention time 40 ±23.5 vs. 26.3 ±25 min, p = 0.0035) and was dependent on time of the local pressure (7.5 ±2.3 vs. 6.5 ±2.8 h, p = 0.03). The RAO increased proportionally to the number of catheters used (p = 0.01) and was dependent on time of the local pressure (8.6 ±3.5 vs. 6.4 ±2.7 h, p < 0.001). CONCLUSIONS: Our study showed that angiography and interventions without routine use of spasmolytic agents were feasible and safe. RAS and RAO are related to independent risk factors and comparable to data from the literature when spasmolytics were used. Termedia Publishing House 2020-06-23 2020-06 /pmc/articles/PMC7333200/ /pubmed/32636897 http://dx.doi.org/10.5114/aic.2020.96056 Text en Copyright: © 2020 Termedia Sp. z o. o. http://creativecommons.org/licenses/by-nc-sa/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International (CC BY-NC-SA 4.0) License, allowing third parties to copy and redistribute the material in any medium or format and to remix, transform, and build upon the material, provided the original work is properly cited and states its license.
spellingShingle Original Paper
Bochenek, Tomasz
Lelek, Michał
Kowal-Kałamajka, Małgorzata
Kusz, Błażej
Szczogiel, Jan
Jaklik, Andrzej
Roleder, Tomasz
Mizia-Stec, Katarzyna
Coronary interventions via radial artery without pre-procedural routine use of spasmolytic agents
title Coronary interventions via radial artery without pre-procedural routine use of spasmolytic agents
title_full Coronary interventions via radial artery without pre-procedural routine use of spasmolytic agents
title_fullStr Coronary interventions via radial artery without pre-procedural routine use of spasmolytic agents
title_full_unstemmed Coronary interventions via radial artery without pre-procedural routine use of spasmolytic agents
title_short Coronary interventions via radial artery without pre-procedural routine use of spasmolytic agents
title_sort coronary interventions via radial artery without pre-procedural routine use of spasmolytic agents
topic Original Paper
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7333200/
https://www.ncbi.nlm.nih.gov/pubmed/32636897
http://dx.doi.org/10.5114/aic.2020.96056
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