Chun Shing Kwok1, Muhammad Rashid2, Doug Fraser3, James Nolan4, Mamas Mamas5. 1. Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, UK. Electronic address: shingkwok@doctors.org.uk. 2. St. Helens & Knowsley Teaching Hospital (NHS) Trust, Whiston Hospital, Prescot, UK. 3. Manchester Heart Centre, Manchester Royal Infirmary, UK. 4. University Hospital of North Midlands, Stoke-on-Trent, UK. 5. Keele Cardiovascular Research Group, Keele University, Stoke-on-Trent, UK; Farr Institute, Institute of Population Health, University of Manchester, Manchester, UK.
Abstract
OBJECTIVES: The aim of this study is to review the available literature on the efficacy and safety of agents used for prevention of RAS. BACKGROUND: Different vasodilator agents have been used to prevent radial artery spasm (RAS) in patients undergoing transradial cardiac catheterization. METHODS: We included studies that evaluated any intra-arterial drug administered in the setting cardiac catheterization that was undertaken through the transradial access site (TRA). We also compared studies for secondary outcomes of major bleeding, procedure time, and procedure failure rate in setting of RAS prevention, patent hemostasis and radial artery occlusion. RESULTS: 22 clinical studies met the inclusion criteria. For placebo, RAS rate was 12% (4 studies, 638 participants), which was similar to 2.5mg of verapamil 12% (3 studies, 768 participants) but greater than 5mg of verapamil (4%, 2 studies, 497 participants). For nicorandil, there was a much higher RAS rate compared to placebo (16%, 3 studies, 447 participants). The lowest rates of RAS was found for nitroglycerin at both 100 μg (4%) and 200 μg (2%) doses, isosorbide mononitrate (4%) and nicardipine (3%). We found no information regarding the procedure failure rates, patent hemostasis, and radial artery occlusion in these studies. CONCLUSIONS: In this largest and up-to-date review on intra-arterial vasodilators use to reduce RAS, we have found that the verapamil at a dose of 5mg or verapamil in combination with nitroglycerine are the best combinations to reduce RAS.
OBJECTIVES: The aim of this study is to review the available literature on the efficacy and safety of agents used for prevention of RAS. BACKGROUND: Different vasodilator agents have been used to prevent radial artery spasm (RAS) in patients undergoing transradial cardiac catheterization. METHODS: We included studies that evaluated any intra-arterial drug administered in the setting cardiac catheterization that was undertaken through the transradial access site (TRA). We also compared studies for secondary outcomes of major bleeding, procedure time, and procedure failure rate in setting of RAS prevention, patent hemostasis and radial artery occlusion. RESULTS: 22 clinical studies met the inclusion criteria. For placebo, RAS rate was 12% (4 studies, 638 participants), which was similar to 2.5mg of verapamil 12% (3 studies, 768 participants) but greater than 5mg of verapamil (4%, 2 studies, 497 participants). For nicorandil, there was a much higher RAS rate compared to placebo (16%, 3 studies, 447 participants). The lowest rates of RAS was found for nitroglycerin at both 100 μg (4%) and 200 μg (2%) doses, isosorbide mononitrate (4%) and nicardipine (3%). We found no information regarding the procedure failure rates, patent hemostasis, and radial artery occlusion in these studies. CONCLUSIONS: In this largest and up-to-date review on intra-arterial vasodilators use to reduce RAS, we have found that the verapamil at a dose of 5mg or verapamil in combination with nitroglycerine are the best combinations to reduce RAS.
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
Authors: Renato Francesco Maria Scalise; Armando Mariano Salito; Alberto Polimeni; Victoria Garcia-Ruiz; Vittorio Virga; Pierpaolo Frigione; Giuseppe Andò; Carlo Tumscitz; Francesco Costa Journal: J Clin Med Date: 2019-10-18 Impact factor: 4.241