Impact of introducer sheath coating on endothelial function in humans after transradial coronary procedures.
BACKGROUND
The aim of this study was to compare the impact of transradial catheterization with hydrophilic-coated catheter sheaths versus uncoated sheaths on NO-mediated endothelial-dependent and -independent vasodilator function.


RESULTS
Thirty-five subjects undergoing transradial catheterization were recruited and assessed before and the day after catheterization. A subgroup was also assessed 3 to 4 months after catheterization. Subjects received hydrophilic-coated sheaths (n=15) or uncoated sheaths (n=20). Radial artery flow-mediated dilatation and endothelium- and NO-dependent arterial dilatation were assessed within the region of sheath placement. Glyceryl trinitrate endothelium-independent NO-mediated function was also assessed. The noncatheterized arm provided an internal control. Flow-mediated dilatation in the catheterized arm decreased from 10.3+/-3.8% to 5.3+/-3.3% and 8.1+/-2.4% to 5.2+/-3.7% in the coated and uncoated groups, respectively (P<0.01). These values returned toward baseline levels approximately 3 months later (coated, 6.4+/-1.4%; uncoated, 9.4+/-4.1%; P<0.05) versus postprocedure. Glyceryl trinitrate decreased from 14.8+/-7.2% to 9.5+/-4.1% (P<0.05) in the coated group and from 12.2+/-4.6% to 7.5+/-4.2% (P<0.01) in the uncoated group. Values returned to baseline at approximately 3 months (coated, 16.6+/-5.6%; uncoated, 12.1+/-3.9%; P<0.05). There was no difference in the magnitude of decrease in flow-mediated dilatation or glyceryl trinitrate between coated and uncoated groups. No changes in function occurred in the noncatheterized arm.


CONCLUSIONS
Placement of a catheter sheath inside the radial artery disrupts vasodilator function, which recovers after 3 months. No differences were evident between hydrophilic-coated and uncoated sheaths.
Dawson
Ellen A
EA
Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, and Liverpool Heart and Chest Hospital, Liverpool, England, UK. e.dawson@ljmu.ac.uk
Rathore
Sudhir
S
Cable
N Timothy
NT
Wright
D Jay
DJ
Morris
John L
JL
Green
Daniel J
DJ
D000328:Adult; D000368:Aged; D002404:Catheterization; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000473:pathology / Q000628:therapy; D054855:Drug-Eluting Stents; D004730:Endothelium, Vascular / Q000187:drug effects / Q000378:metabolism* / Q000473:pathology; D045462:Endothelium-Dependent Relaxing Factors / Q000008:administration & dosage; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009569:Nitric Oxide / Q000008:administration & dosage; D005996:Nitroglycerin / Q000008:administration & dosage; D017534:Radial Artery / Q000473:pathology* / Q000601:surgery
D045462:Endothelium-Dependent Relaxing Factors; D009569:Nitric Oxide; D005996:Nitroglycerin