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Different Spasmolytic Regimens (Nitroglycerin vs Verapamil) and the Incidence of Radial Artery Occlusion After Transradial Catheterization.

Publication ,  Journal Article
Dharma, S; Kedev, S; Patel, T; Rao, SV; Gilchrist, IC
Published in: J Invasive Cardiol
December 2018

OBJECTIVE: This study evaluated whether use of different spasmolytic regimens (nitroglycerin or verapamil) administered soon after sheath insertion affects postprocedure radial artery occlusion (RAO) in patients who underwent transradial catheterization. METHODS AND RESULTS: We performed a post hoc analysis of a randomized trial evaluating the use of 500 μg intra-arterial nitroglycerin just before sheath removal in 1706 patients undergoing transradial catheterization. Patients who received 200 μg or 300 μg nitroglycerin after sheath placement (group A; n = 688) were compared with patients who received 5 mg verapamil after sheath placement (group B; n = 1018). The primary endpoint was RAO diagnosed by Doppler ultrasound examination at 1 calendar day after the procedure. Logistic regression was used to determine predictors of RAO. RAO occurred in 16.0% of group A and 5.4% of group B. After adjustment for potential confounders, neither the use of verapamil nor nitroglycerin was associated with RAO (odds ratio [OR], 1.24; 95% confidence interval [CI], 0.51-3.02; P=.62). Radial artery compression >4 hours was the strongest predictor of RAO (OR, 5.41; 95% CI, 2.31-12.65; P<.001). CONCLUSIONS: In this study, the use of verapamil or nitroglycerin as a spasmolytic regimen was not associated with RAO. Given the strong association between duration of radial compression and RAO, further studies are needed to determine the interaction between vasodilator agents and compression protocols on RAO.

Duke Scholars

Published In

J Invasive Cardiol

EISSN

1557-2501

Publication Date

December 2018

Volume

30

Issue

12

Start / End Page

461 / 464

Location

United States

Related Subject Headings

  • Verapamil
  • Vasodilator Agents
  • Ultrasonography, Doppler
  • Republic of North Macedonia
  • Radial Artery
  • Nitroglycerin
  • Middle Aged
  • Male
  • Injections, Intra-Arterial
  • Indonesia
 

Citation

APA
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ICMJE
MLA
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Dharma, S., Kedev, S., Patel, T., Rao, S. V., & Gilchrist, I. C. (2018). Different Spasmolytic Regimens (Nitroglycerin vs Verapamil) and the Incidence of Radial Artery Occlusion After Transradial Catheterization. J Invasive Cardiol, 30(12), 461–464.
Dharma, Surya, Sasko Kedev, Tejas Patel, Sunil V. Rao, and Ian C. Gilchrist. “Different Spasmolytic Regimens (Nitroglycerin vs Verapamil) and the Incidence of Radial Artery Occlusion After Transradial Catheterization.J Invasive Cardiol 30, no. 12 (December 2018): 461–64.
Dharma S, Kedev S, Patel T, Rao SV, Gilchrist IC. Different Spasmolytic Regimens (Nitroglycerin vs Verapamil) and the Incidence of Radial Artery Occlusion After Transradial Catheterization. J Invasive Cardiol. 2018 Dec;30(12):461–4.
Dharma S, Kedev S, Patel T, Rao SV, Gilchrist IC. Different Spasmolytic Regimens (Nitroglycerin vs Verapamil) and the Incidence of Radial Artery Occlusion After Transradial Catheterization. J Invasive Cardiol. 2018 Dec;30(12):461–464.

Published In

J Invasive Cardiol

EISSN

1557-2501

Publication Date

December 2018

Volume

30

Issue

12

Start / End Page

461 / 464

Location

United States

Related Subject Headings

  • Verapamil
  • Vasodilator Agents
  • Ultrasonography, Doppler
  • Republic of North Macedonia
  • Radial Artery
  • Nitroglycerin
  • Middle Aged
  • Male
  • Injections, Intra-Arterial
  • Indonesia