eISSN: 1897-4295
ISSN: 1734-9338
Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej
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SCImago Journal & Country Rank
1/2024
vol. 20
 
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abstract:
Original paper

Radial artery spasms – angiographic morphology, risk factors and management

Jan Roczniak
1
,
Andrzej Tarnawski
2
,
Artur Dziewierz
1, 3
,
Szymon Glanowski
4
,
Artur Pawlik
1
,
Karol Sabatowski
1
,
Rafał Januszek
5
,
Łukasz Rzeszutko
1, 3
,
Andrzej Surdacki
1, 3
,
Stanisław Bartuś
1, 3
,
Michał Chyrchel
1, 3

  1. Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
  2. University of California, Irvine, USA
  3. Second Department of Cardiology, Faculty of Medicine, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
  4. Students’ Scientific Group at the Second Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
  5. Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Cracow University, Krakow, Poland
Adv Interv Cardiol 2024; 20, 1 (75): 53–61
Online publish date: 2024/03/22
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Introduction:
Radial artery is the preferred access for coronary interventions. However, the procedure is sometimes interrupted by a spasm which causes pain, prolongs the procedure, and can force the access crossover.

Aim:
To observe factors contributing to a symptomatic radial artery spasm.

Material and methods:
In this prospective study, we present results of 103 consecutive patients regarding radial artery spasm and angiographic image of the punctured artery. Angiography of the radial artery was performed in 70 (68.0%) patients. Potential risk factors for radial artery spasm were evaluated.

Results:
The overall incidence of the radial artery spasm was high – 25 (24.3%). Signs of spasm were present in 37.1% of radial artery angiographies before the procedure and 60.1% after, however, it did not always indicate a symptomatic spasm. Risk factors related to radial artery spasm included female sex (OR = 2.94, p = 0.02), failure of the first puncture attempt (OR = 3.12, p = 0.014) and use of non-hydrophilic sheath (OR = 9.56, p = 0.036). Radial artery narrowing at the tip of the sheath was also a risk factor for spasm (p = 0.022). No spasms were observed after hydrophilic sheath application (n = 13). The administration of a radial cocktail was not observed to significantly decrease the spasm odds.

Conclusions:
Risk factors for radial artery spasm include female sex and multiple puncture attempts. Hydrophilic sheath coating protects against radial artery spasm. Overall signs of a spasm in the angiography are common and do not imply a symptomatic spasm, which can be predicted by a tight narrowing at the tip of the sheath.

keywords:

cardiovascular interventions, radial access, radial artery angiography, radial artery spasm

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