Babu Ezhumalai1, Santhosh Satheesh2, Balachander Jayaraman2. 1. Department of Cardiology, Sri Venkateshwaraa Medical College Hospital and Research Centre, Puducherry, India. Electronic address: drebabu@gmail.com. 2. Department of Cardiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
Abstract
BACKGROUND: The success of transradial catheterization depends on meticulous access of radial artery which in turn depends on palpating a good radial pulse. OBJECTIVES: Our objectives were to analyze the effects of subcutaneously infiltrated nitroglycerin on diameter of radial artery, palpability of radial pulse, ease-of-puncture and pre-cannulation spasm of radial artery during transradial coronary angiography. METHODS:Patients undergoing transradial coronary angiography were randomized to Group NL or Group SL. In Group NL, 3 ml of solution containing nitroglycerin and lignocaine was infiltrated subcutaneously at the site intended for puncture of radial artery. Similarly, saline and lignocaine were infiltrated in Group SL. Diameter of radial artery was objectively assessed by ultrasonography. Measurements were performed at baseline and repeated at 1 min after injecting the solutions. The ease-of-puncture was evaluated by the number of punctures and the time needed for successful access of radial artery. RESULTS: Both groups had 100 patients each. Baseline diameter of radial artery was similar between two groups. The post-injection diameter of radial artery increased by 26.3% in Group NL and 11.4% in Group SL. Nitroglycerin significantly improved the palpability of radial pulse, reduced the number of punctures and shortened the time needed for successful access of radial artery. Pre-cannulation spasm of radial artery occurred in 1% of Group NL and 8% of Group SL. CONCLUSIONS:Subcutaneously infiltrated nitroglycerin leads to significant vasodilation of radial artery. This avoids pre-cannulation spasm of radial artery, enhances palpability of the radial pulse and thus makes the puncture of radial artery easier.
RCT Entities:
BACKGROUND: The success of transradial catheterization depends on meticulous access of radial artery which in turn depends on palpating a good radial pulse. OBJECTIVES: Our objectives were to analyze the effects of subcutaneously infiltrated nitroglycerin on diameter of radial artery, palpability of radial pulse, ease-of-puncture and pre-cannulation spasm of radial artery during transradial coronary angiography. METHODS:Patients undergoing transradial coronary angiography were randomized to Group NL or Group SL. In Group NL, 3 ml of solution containing nitroglycerin and lignocaine was infiltrated subcutaneously at the site intended for puncture of radial artery. Similarly, saline and lignocaine were infiltrated in Group SL. Diameter of radial artery was objectively assessed by ultrasonography. Measurements were performed at baseline and repeated at 1 min after injecting the solutions. The ease-of-puncture was evaluated by the number of punctures and the time needed for successful access of radial artery. RESULTS: Both groups had 100 patients each. Baseline diameter of radial artery was similar between two groups. The post-injection diameter of radial artery increased by 26.3% in Group NL and 11.4% in Group SL. Nitroglycerin significantly improved the palpability of radial pulse, reduced the number of punctures and shortened the time needed for successful access of radial artery. Pre-cannulation spasm of radial artery occurred in 1% of Group NL and 8% of Group SL. CONCLUSIONS: Subcutaneously infiltrated nitroglycerin leads to significant vasodilation of radial artery. This avoids pre-cannulation spasm of radial artery, enhances palpability of the radial pulse and thus makes the puncture of radial artery easier.
Authors: Pierfrancesco Agostoni; Giuseppe G L Biondi-Zoccai; M Luisa de Benedictis; Stefano Rigattieri; Marco Turri; Maurizio Anselmi; Corrado Vassanelli; Piero Zardini; Yves Louvard; Martial Hamon Journal: J Am Coll Cardiol Date: 2004-07-21 Impact factor: 24.094
Authors: Roger Barranco-Pons; Isabel Rodríguez Caamaño; Anna Nuñez Guillen; Oscar Sabino Chirife; Helena Quesada; Pere Cardona Journal: Neuroradiology Date: 2021-11-12 Impact factor: 2.804