Minerva Cardioangiologica 2021 Jan 11

DOI: 10.23736/S0026-4725.20.05463-8

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

A randomized trial of flow-mediated dilation to prevent radial artery spasm during transradial approach

Ertugrul ZENCIRCI ¹ ✉, Aycan ESEN ZENCIRCI ², Aleks DEGIRMENCIOGLU ¹

¹ Department of Cardiology, Acıbadem Mehmet Ali Aydınlar University School of Medicine, Istanbul, Turkey; ² Department of Cardiology, Siyami Ersek Cardiovascular and Thoracic Surgery Training and Research Hospital, Istanbul, Turkey

BACKGROUND: Although transradial approach has been increasingly preferred for percutaneous coronary interventions, radial artery spasm (RAS) is still one of the major disadvantage. Flow-mediated dilation (FMD) is a well-known method for assessing endothelial function through dilation. The aim of this study was to investigate the efficacy of prepuncture flow mediated dilation in preventing RAS during transradial approach.
METHODS: The present study prospectively included 222 consecutive patients who underwent transradial coronary intervention. Patients were 1:1 randomized into two groups who underwent prepuncture FMD and who did not (FMD [+] and FMD [-], respectively).
RESULTS: In FMD [+] group the incidence of RAS was lower (5.4% vs 16.2%, p=0.009). Multivariate logistic regression analysis demonstrated that female sex, more than two catheter usage and transradial approach without prepuncture FMD independently predicted RAS (odds ratio (OR): 4.66, 95% confidence interval [CI]: 1.8-12.06, p=0.001, OR: 5.73, 95%CI: 2.01-16.39, p=0.001, and OR: 5.01, 95% CI: 1.74-14.48, p=0.003; respectively). However, access site crossover number was very low in both groups and not different between groups.
CONCLUSIONS: Prepuncture FMD can significantly reduce RAS during transradial coronary interventions. Thus, prepuncture FMD can be used as a simple adjunctive method to prevent RAS.

KEY WORDS: Coronary angiography; Radial artery; Transradial approach