TY - JOUR
TI - Radial Artery Flow-Mediated Dilation Predicts Arterial Spasm During
Transradial Coronary Interventions
AU - Deftereos, Spyridon
AU - Giannopoulos, Georgios
AU - Kossyvakis,
AU - Charalampos
AU - Driva, Metaxia
AU - Kaoukis, Andreas
AU - Raisakis,
AU - Konstantinos
AU - Theodorakis, Andreas
AU - Panagopoulou, Vasiliki and
AU - Lappos, Spyridon
AU - Tampaki, Eleni
AU - Pyrgakis, Vlasios and
AU - Stefanadis, Christodoulos
JO - Catheterization and Cardiovascular Interventions (Formerly Catheterization and Cardiovascular Diagnosis)
PY - 2011
VL - 77
TODO - 5
SP - 649-654
PB - Wiley-Blackwell
SN - 1522-1946, 1522-726X
TODO - 10.1002/ccd.22688
TODO - percutaneous coronary intervention; transradial access; radial artery;
flow-mediated dilation; spasm
TODO - Background: Transradial coronary catheterization has emerged over the
last years as a favorable catheterization practice, based on evidence
that it is associated with less vascular complications and shorter
hospital stays. However, access site crossover appears to be more
frequent when the initial route is the transradial one, one of the main
reasons being arterial spasm. We hypothesized that radial flow-mediated
dilation (FMD) measurements could be used as a preprocedural method to
assess the likelihood of arterial spasm. Methods: The study population
consisted of patients scheduled for transradial diagnostic
catheterization in whom ad hoc percutaneous coronary intervention (PCI)
was performed. FMD was measured 1-2 days before PCI. The primary
endpoint of the study was operator-defined (operators were blinded as to
the FMD results) radial artery spasm. Results: A total of 172 patients
(110 male, age 65.3 +/- 9) were included. Radial artery spasm was
recorded in 13 patients (7.6%). FMD showed a very significant
univariate association with the occurrence of spasm (P < 0.001) and was
the most important predictor of spasm in the multivariate logistic
regression analysis (beta -3.15; P < 0.001), followed by baseline radial
artery diameter (P = 0.04), the number of catheters used (P = 0.049) and
the administered volume of contrast medium (P = 0.017). Conclusion:
Preprocedural FMD is a significant predictor of arterial spasm before
elective transradial PCI. It is a low cost, safe, and feasible
noninvasive modality, whose results might be taken into account when
deciding on the vascular access route for an elective procedure, the
size of sheaths or catheters to be used or the intensity of antispasm
medication. (C) 2010 Wiley-Liss, Inc.
ER -