Radial Artery Spasm in Transradial Cardiac Catheterization. Assessment of Factors Related to Its Occurrence, and of Its Consequences During Follow-up

• Published in: Revista española de cardiologia 2005-05, Vol.58 (5), p.504-511
• Main Authors: Ruiz-Salmerón, Rafael J., Mora, Ramón, Vélez-Gimón, Manuel, Ortiz, José, Fernández, Carlos, Vidal, Bárbara, Masotti, Mónica, Betriu, Amadeo
• Format: Article
• Language: eng ; spa
• Subjects: Angiografía; Angiography; Cardiac catheterization; Cardiac Catheterization - adverse effects; Cateterismo cardíaco; Female; Follow-Up Studies; Humans; Male; Middle Aged; Radial Artery; Spasm - etiology; Vasospasm; Vasospasmo
• ISSN: 1885-5857; 0300-8932; 1885-5857
• DOI: 10.1016/S1885-5857(06)60730-5

Radial artery spasm is the most frequent complication of transradial cardiac catheterization. It causes patient discomfort and reduces the procedure's success rate. The aims of this study were to identify variables associated with this complication, such as clinical parameters, angiographic characteristics of the radial artery and factors related to the procedure, and to analyze the clinical consequences of spasm, both generally and for radial artery patency, during follow-up. The study included 637 patients who were undergoing transradial cardiac catheterization. Radial artery spasm was recorded using a scale that reflected the presence of pain and the technical difficulty of the procedure. Radial artery spasm was reported in 127 patients (20.2%). Multivariate analysis showed that the variables associated with radial artery spasm were radial artery anatomical anomalies (odds ratio [OR]=5.1; 95% confidence interval [95% Cl], 2.1–11.4), use of > size-3 catheters (OR=3.0; 95% Cl, 1.9–4.7), moderate-to-severe pain during radial artery cannulation (OR=2.6; 95% Cl, 1.4–4.9), the use of phentolamine as a spasmolytic (OR=1.8; 95% Cl, 1.1–2.9), and postvasodilation radial artery diameter (OR=0.98; 95% Cl, 0.98–0.99). At follow-up (20 [18] days), severe pain in the forearm was more frequent in patients who presented with radial artery spasm (12.4% vs 5.3%), but there was no significant difference in the radial artery occlusion rate (4.5% vs 2.2%). Radial artery spasm during transradial catheterization mainly depends on radial artery characteristics and procedural variables. At follow-up, radial artery spasm was associated with more frequent severe pain in the forearm, but the radial artery occlusion rate was not increased. El espasmo radial es la complicación más frecuente en el cateterismo cardíaco transradial y ocasiona un procedimiento más doloroso para el paciente, con una menortasa de éxito. El objetivo es analizar los factores que se asocian con el espasmo radial durante el cateterismo cardíaco (variables clínicas, características angiográficas de la arteria radial y variables del procedimiento), así como sus consecuencias (clínicas y de permeabilidad de la arteria radial) en el seguimiento. Se ha incluido a 637 pacientes en los que se realizó un cateterismo cardíaco por vía radial. El espasmo radial se registró segün una escala que valora las molestias del paciente y las dificultades técnicas. Se produjo espasmo radial en 127 pacientes (20,2%). El análisis m