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

Abstract

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.

Catheter entrapment due to severe radial artery spasm during transradial approach

“…Case Age Gender Height 0.7% [13,19]. In the present study, the incidence of RAS and severe RAS was found to be correlated with these previous findings and to the best of our knowledge, this is the first report that reveals the incidence of catheter entrapment due to severe RAS.…”

“…However, in the present study, catheter entrapment due to catheter kinking was not encountered. Several RAS-associated factors have been identified, including patient-related factors (female www.cardiologyjournal.org gender, young age, low body mass index, short stature, small radial artery diameter, diabetes mellitus, dyslipidemia, anxiety, anomalous radial artery), and technical factors (low radial artery to sheath ratio, non-hydrophilic coated sheaths, unsuccessful access at first attempt, prolonged cannulation, multiple catheter exchanges, excessive catheter manipulations, limited operator experience) [8,13,[15][16][17][22][23][24]. In the present study, it was demonstrated that the catheter entrapment-associated factors were similar to these previously defined factors.…”

“…Catheter entrapment was defined as severe local pain associated with catheter trapping which restricts manipulation of catheter due to severe RAS [13].…”

The effect of pre-procedure sublingual nitroglycerin on radial artery diameter and Allen's test outcome - Relevance to transradial catheterization

“…The intra-arterial administration of drugs does however first necessitate initial successful puncture and sheath insertion into the radial artery. This can be problematic as repeated attempts at gaining access of the radial artery itself are associated with spasm, hematoma formation and procedure failure (7). In SAFE-PCI for Women, access site crossover from transradial to transfemoral occurred more than 3 times as frequently in the presence of arterial spasm (8).…”

Can radial artery pulse grading predict radial artery spasm during transradial approach?

“…Several RAS-associated factors have been identified including patient-related factors (female gender, young age, low body mass index, short stature, small radial artery diameter, diabetes mellitus, dyslipidaemia, anxiety, anomalous radial artery) and technical factors (low radial-artery-to-sheath ratio, non-hydrophilic coated sheaths, unsuccessful access at first attempt, prolonged cannulation, multiple catheter exchanges, excessive catheter manipulations, limited operator experience) [8,[15][16][17][18][19][20][21]. In the present study, radial artery pulse grading, which was found to be correlated with radial artery diameter, female sex, and larger catheter size were demonstrated as predictors of RAS.…”