Incidence and predictors of radial artery spasm during transradial coronary angiography and intervention.
- Author:
De-An JIA
1
;
Yu-Jie ZHOU
;
Dong-Mei SHI
;
Yu-Yang LIU
;
Jian-Long WANG
;
Xiao-Li LIU
;
Zhi-Jian WANG
;
Shi-Wei YANG
;
Hai-Long GE
;
Bin HU
;
Zhen-Xian YAN
;
Yi CHEN
;
Fei GAO
Author Information
- Publication Type:Journal Article
- MeSH: Age Factors; Aged; Coronary Angiography; adverse effects; Coronary Vasospasm; epidemiology; etiology; Female; Humans; Logistic Models; Male; Middle Aged; Radial Artery; Sex Factors
- From: Chinese Medical Journal 2010;123(7):843-847
- CountryChina
- Language:English
-
Abstract:
BACKGROUNDRadial artery spasm (RAS) is the most common complication in transradial coronary angiography and intervention. In this study, we designed to investigate the incidence of RAS during transradial procedures in Chinese, find out the independent predictors through multiple regression, and analyze the clinical effect of RAS during follow-up.
METHODSPatients arranged to receive transradial coronary angiography and intervention were consecutively enrolled. The incidence of RAS was recorded. Univariate analysis was performed to find out the influence factors of RAS, and logistic regression analysis was performed to find out the independent predictors of RAS. The patients were asked to return 1 month later for the assessment of the radial access.
RESULTSThe incidence of RAS was 7.8% (112/1427) in all the patients received transradial procedure. Univariate analysis indicates that young (P = 0.038), female (P = 0.026), small diameter of radial artery (P < 0.001), diabetes (P = 0.026), smoking (P = 0.019), moderate or severe pain during radial artery cannulation (P < 0.001), unsuccessful access at first attempt (P = 0.002), big sheath (P = 0.004), number of catheters (> 3) (P = 0.048), rapid baseline heart rate (P = 0.032) and long operation time (P = 0.021) were associated with RAS. Logistic regression showed that female (OR = 1.745, 95%CI: 1.148 - 3.846, P = 0.024), small radial artery diameter (OR = 4.028, 95%CI: 1.264 - 12.196, P = 0.008), diabetes (OR = 2.148, 95%CI: 1.579 - 7.458, P = 0.019) and unsuccessful access at first attempt (OR = 1.468, 95%CI: 1.212 - 2.591, P = 0.032) were independent predictors of RAS. Follow-up at (28 +/- 7) days after the procedure showed that, compared with non-spasm patients, the RAS patients had higher portion of pain (11.8% vs. 6.2%, P = 0.043). The occurrences of hematoma (7.3% vs. 5.6%, P = 0.518) and radial artery occlusion (3.6% vs. 2.6%, P = 0.534) were similar.
CONCLUSIONSThe incidence of RAS during transradial coronary procedure was 7.8%. Logistic regression analysis showed that female, small radial artery diameter, diabetes and unsuccessful access at first attempt were the independent predictors of RAS.
