A predictive score of radial artery spasm in patients undergoing transradial percutaneous coronary intervention

Γιαννόπουλος, Γεώργιος; Raisakis, Konstantinos; Synetos, Αndreas; Davlouros, Periklis; Hahalis, George; Alexopoulos, Dimitrios; Tousoulis, Dimitrios; Lekakis, John; Stefanadis, Christodoulos; Cleman, Michael; Deftereos, Spyridon

doi:10.1016/j.ijcard.2015.04.024

Cited by 23 publications

(19 citation statements)

References 16 publications

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“…However, smoking was found to be inversely related with RAS in an FMD study performed by Deftereos et al which is in analogy to our data. 18,19 They explained this phenomenon with a "smoking paradox" and reported that the relationship was not consistent after necessary adjustments. 18 Anxiety was also shown to be in close association with abnormal blood flow patterns based on endothelial dysfunction, which most probably exhibits its role in RAS pathophysiology.…”

Section: Discussionmentioning

confidence: 99%

Comparing of Efficacy of Different Self-Assessment Anxiety Scales for Predicting Radial Artery Spasm During Coronary Interventions

Omaygenç¹,

Karaca²,

İbişoğlu³

et al. 2019

Turkiye Klinikleri J Cardiovasc Sci

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Section: Discussionmentioning

confidence: 99%

Comparing of Efficacy of Different Self-Assessment Anxiety Scales for Predicting Radial Artery Spasm During Coronary Interventions

Omaygenç¹,

Karaca²,

İbişoğlu³

et al. 2019

Turkiye Klinikleri J Cardiovasc Sci

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“…A weighted risk score was created using adjusted multivariate odds ratios, consistent with previous risk score computations. [ 15 ] Patients were stratified by the unweighted risk score into groups. Those groups with fewer than 100 cases were considered together as a single group which applied to unweighted scores of ≥8.…”

Section: Methodsmentioning

confidence: 99%

Risk factors for wound complications following spine surgery

Piper¹,

Tomlinson²,

Santangelo³

et al. 2017

Surg Neurol Int

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Background:Wound complications, including surgical site infections (SSIs) and wound dehiscence, are among the most common complications following spine surgery often leading to readmission. The authors sought to identify preoperative characteristics predictive of wound complications after spine surgery.Methods:The American College of Surgeons National Surgical Quality Improvement Program database for years 2012–2014 was reviewed for patients undergoing spine surgery, defined by the Current Procedural Terminology codes. Forty-four preoperative and surgical characteristics were analyzed for associations with wound complications.Results:Of the 99,152 patients included in this study, 2.2% experienced at least one wound complication (superficial SSI: 0.9%, deep SSI: 0.8%, organ space SSI: 0.4%, and dehiscence: 0.3%). Multivariate binary logistic regression testing found 10 preoperative characteristics associated with wound complications: body mass index ≥30, smoker, female, chronic steroid use, hematocrit <38%, infected wound, inpatient status, emergency case, and operation time >3 hours. A risk score for each patient was created from the number of characteristics present. Receiver operating characteristic curves of the unweighted and weighted risk scores generated areas under the curve of 0.701 (95% CI: 0.690–0.713) and 0.715 (95% CI: 0.704–0.726), respectively. Patients with unweighted risk scores >7 were 25-fold more likely to develop a wound complication compared to patients with scores of 0. In addition, mortality rate, reoperation rate, and total length of stay each increased nearly 10-fold with increasing risk score.Conclusion:This study introduces a novel risk score for the development of wound dehiscence and SSIs in patients undergoing spine surgery, using new risk factors identified here.

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“…The reported frequency of spasm in the transradial approach presents huge variations in the literature ranging from 4% to higher than 20% in line with the 12% reported in the present work [ 12 , 13 ]. Numerous factors predisposing to RAS have been identified in the published data including BMI < 25 kg/m 2 , height <170 cm, current smoking, PAD, age, complexity of the procedure, anatomical variations and large radial sheaths and catheter [ 11 ]. To allow a better identification of high risk patients, an RAS risk score has been recently proposed by Giannopoulos et al based on five weighted variables (see methods) with a cut-off of four to predict spasm with a sensitivity of 84.5% and a specificity of 74.7% [ 11 ].…”

Section: Discussionmentioning

confidence: 99%

“…An RAS risk score was calculated for all patients as recently proposed by Giannopulos and coworkers [ 11 ]. It consists of five weighted risk factors for radial artery spasm: body mass index (BMI) less than 25 kg/m 2 (1 point), height less than 170 cm (1 point), current smoking (2 points), hypertension (2 points) and PAD (3 points).…”

Section: Methodsmentioning

confidence: 99%

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Impact of Opioid Analgesia and Inhalation Sedation Kalinox on Pain and Radial Artery Spasm during Transradial Coronary Angiography

Birgy

Trimaille

Messas

et al. 2020

JCM

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With respect to the transfemoral approach, transradial procedures enable a drastic reduction of bleeding events and are associated with a reduction of mortality. Radial artery spasm (RAS) is one of the most common complications and may lead to patient discomfort and procedural failure. Currently, there is no consensus on the optimal sedation protocol to avoid RAS. The aim of this study was to investigate the respective impact of opioids analgesia and inhalation sedation with a 50% nitrous oxide/oxygen premix (Kalinox) on pain and occurrence of RAS during transradial coronary procedures. Consecutive patients undergoing transradial coronary angiography were prospectively enrolled in one, single center observational study (Nouvel Hôpital Civil, Strasbourg, France). Patients received opioids analgesia or inhalation sedation with Kalinox. The primary endpoints of the study were the incidence of a pain scale ≥5/10 and the occurrence of RAS. The secondary endpoints were the incidence of side effects. A total of 325 patients were enrolled (185 in the opioids analgesia group, 140 in the Kalinox group). RAS and pain scale ≥5 rates were not significantly different in the opioids analgesia and Kalinox groups (respectively 13.5% vs. 10.0% and 16.2% vs. 11.4%). Headache was more frequently observed in the Kalinox group (6.4% vs. 0.0%; p = 0.002). By multivariate analysis, female gender, BMI <25 kg/m2, puncture difficulty, the use of plastic needle and 6F sheath were identified as independent predictors of RAS. Procedural inhalation sedation by Kalinox is as safe as opioids analgesia during transradial coronary angiography.

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A predictive score of radial artery spasm in patients undergoing transradial percutaneous coronary intervention

Cited by 23 publications

References 16 publications

Comparing of Efficacy of Different Self-Assessment Anxiety Scales for Predicting Radial Artery Spasm During Coronary Interventions

Comparing of Efficacy of Different Self-Assessment Anxiety Scales for Predicting Radial Artery Spasm During Coronary Interventions

Risk factors for wound complications following spine surgery

Impact of Opioid Analgesia and Inhalation Sedation Kalinox on Pain and Radial Artery Spasm during Transradial Coronary Angiography

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