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Catheter Cardiovasc Interv. 2014 Jan 1;83(1):E32-6. doi: 10.1002/ccd.25082. Epub 2013 Jul 19.

Radial artery spasm associated with transradial cardiovascular procedures: results from the RAS registry.

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  • 1Department of Interventional Cardiology, Sanatorio Guemes, Buenos Aires, Argentina.

Abstract

OBJECTIVES:

To report the incidence and predictors of moderate/severe radial artery spasm (RAS) in patients undergoing cardiovascular percutaneous procedures through a transradial approach (TRA) in centers with TRA expertise.

BACKGROUND:

Data regarding the actual rate of clinically meaningful RAS are limited due to difference in study designs and operator expertise.

METHODS:

The RAS registry, an international (14 centers from Argentina, Chile, India, Indonesia, Macedonia, The Netherlands and United States of America) registry that included 1,868 patients undergoing TRA cardiovascular procedures (63.5% diagnostic and 56.5% therapeutic).All selected centers used TRA as default strategy in the cardiac catheterization laboratory. Throughout 2012, each center included all consecutive TRA cases (during a 2-month period) into a dedicated database covering clinical characteristics as well as procedural topics related to TRA patterns and RAS occurrence.

RESULTS:

The incidence of moderate/severe RAS was 2.7%. Only 0.7% of patients required crossover (8 to transfemoral and 5 to contralateral TRA). Patients with moderately/severe spasm were more frequently females, had a history of dyslipidemia, received more often a 7F sheath and more puncture attempts than patients without spasm. By multivariate analysis, the need for more than one attempt and the use of a 7 F sheath were independent predictors of the development of moderate/severe RAS.

CONCLUSIONS:

The incidence of moderate/severe RAS is low in centers with a default TRA. Its development appears to be strongly related to the numbers of puncture attempts and the use of large sheaths.

Copyright © 2013 Wiley Periodicals, Inc.

KEYWORDS:

ANGO, angiography coronary; CAD; TRAD, transradial cath; coronary artery disease

PMID:
23785005
[PubMed - indexed for MEDLINE]
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