Comparative study of the use of diltiazem as an antispasmodic drug in coronary angiography via the transradial approach.
OBJECTIVE
To evaluate the impact of the use, prior to the procedure, of injectable diltiazem to prevent complications.


METHODS
Between September 2000 and July 2001, 50 patients underwent transradial coronary angiography and were randomized to receive placebo (GI) or diltiazem (GII) through a catheter inserted into the radial artery. All patients received isosorbide mononitrate. Ultrasound analyses of the radial artery were performed before examination, 30 minutes afterwards, and 7 days afterwards to evaluate the flow, the diameter, and the artery output.


RESULTS
The radial artery diameter of GI was 2.4d +/- 0.5 mm before the procedure and 2.3 +/- 0.5 mm after 30 minutes (NS), whereas in GII the diameter was 2.2 +/- 0.3 mm before the examination and +/- 2.5 0.4 mm 30 minutes after it (P<0.001). Radial artery output in group 1 was 7.3 +/- 5.l2 mL/min before the examination and 6.1 +/- 3.5 mL/min 30 minutes after the examination (NS), and GII had an increase of 5.9 +/- 2.5 mL/min before examination to 9.05 +/- 7.78 mL/min after the examination (P=0.04). Complications (spasm, occlusion, and partial obstruction) occurred in 4 patients (17.4%) in GI and did not occur in GII (P=0.04).


CONCLUSIONS
The study suggests a decrease in vascular complications through the transradial access for coronary angiography with the use of diltiazem as an antispasmodic drug, resulting in the significant increase in the diameter of the radial artery and radial artery output.
Mont'Alverne Filho
José Ronaldo
JR
Instituto Dante Pazzanese de Cardiologia, São Paulo, SP, Brazil.
Assad
João Alexandre Rezende
JA
Zago
Alexandre do Canto
Ado C
da Costa
Ricardo Leite Vieira
RL
Pierre
Antonio Guarany Mont'Alverne
AG
Saleh
Mohamed Hassan
MH
Barretto
Rodrigo
R
Braga
Sérgio Luiz Navarro
SL
Feres
Fausto
F
Sousa
Amanda Guerra Moraes Rego
AG
Sousa
José Eduardo Moraes Rego
JE
D002318:Cardiovascular Diseases / Q000517:prevention & control*; D017023:Coronary Angiography / Q000009:adverse effects* / Q000379:methods; D004110:Diltiazem / Q000627:therapeutic use*; D004234:Diuretics, Osmotic / Q000494:pharmacology; D004311:Double-Blind Method; D004359:Drug Therapy, Combination; D005260:Female; D006801:Humans; D007547:Isosorbide / Q000494:pharmacology; D008297:Male; D008875:Middle Aged; D010276:Parasympatholytics / Q000627:therapeutic use*; D017534:Radial Artery / Q000033:anatomy & histology / Q000187:drug effects* / Q000502:physiology
D004234:Diuretics, Osmotic; D010276:Parasympatholytics; D004110:Diltiazem; D007547:Isosorbide