title: [Radial artery spasm in transradial cardiac catheterization. Assessment of factors related to its occurrence, and of its consequences during follow-up].
abstract: OBJECTIVE
  Radial artery spasm is the most frequent complication of transradial cardiac catheterization. It causes patient discomfort and reduces the procedure's success rate. The aims of this study were to identify variables associated with this complication, such as clinical parameters, angiographic characteristics of the radial artery and factors related to the procedure, and to analyze the clinical consequences of spasm, both generally and for radial artery patency, during follow-up.
  
  
  METHODS
  The study included 637 patients who were undergoing transradial cardiac catheterization. Radial artery spasm was recorded using a scale that reflected the presence of pain and the technical difficulty of the procedure.
  
  
  RESULTS
  Radial artery spasm was reported in 127 patients (20.2%). Multivariate analysis showed that the variables associated with radial artery spasm were radial artery anatomical anomalies (odds ratio [OR]=5.1; 95% confidence interval [95% CI]: 2.1-11.4), use of >size-3 catheters (OR=3.0; 95% CI: 1.9-4.7), moderate-to-severe pain during radial artery cannulation (OR=2.6; 95% CI: 1.4-4.9), the use of phentolamine as a spasmolytic (OR=1.8; 95% CI: 1.1-2.9), and postvasodilation radial artery diameter (OR=0.98; 95% CI: 0.98-0.99). At follow-up [20 (18) days], severe pain in the forearm was more frequent in patients who presented with radial artery spasm (12.4% vs 5.3%), but there was no significant difference in the radial artery occlusion rate (4.5% vs 2.2%).
  
  
  CONCLUSIONS
  Radial artery spasm during transradial catheterization mainly depends on radial artery characteristics and procedural variables. At follow-up, radial artery spasm was associated with more frequent severe pain in the forearm, but the radial artery occlusion rate was not increased.
authors.affiliation: Departamento de Hemodinámica y Cardiología Intervencionista, Hospital Clínic, Barcelona, España. rjruiz@clinic.ub.es
authors.forename: Rafael J
authors.initials: RJ
authors.lastname: Ruiz-Salmerón
authors.forename: Ramón
authors.initials: R
authors.lastname: Mora
authors.forename: Manuel
authors.initials: M
authors.lastname: Vélez-Gimón
authors.forename: José
authors.initials: J
authors.lastname: Ortiz
authors.forename: Carlos
authors.initials: C
authors.lastname: Fernández
authors.forename: Bárbara
authors.initials: B
authors.lastname: Vidal
authors.forename: Mónica
authors.initials: M
authors.lastname: Masotti
authors.forename: Amadeo
authors.initials: A
authors.lastname: Betriu
mesh_terms: D006328:Cardiac Catheterization / Q000009:adverse effects*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017534:Radial Artery; D013035:Spasm / Q000209:etiology*