Reduction in spasm with a long hydrophylic transradial sheath.
OBJECTIVE
We aimed to assess the efficiency of a long hydrophilic sheath in reducing radial spasm for transradial approach.


BACKGROUND
Despite a lower access site complication rate, cardiac catheterization using transradial approach is not widely used. Radial spasm is one of the main issues for transradial angiography and percutaneous interventions. We assumed that radial artery protection using a long hydrophilic-coated sheath would reduce radial spasm compared to a bare short sheath.


METHODS
Three hundred and fifty one patients (pts) admitted for transradial coronary angiography ± percutaneous coronary interventions were randomly assigned to a long hydrophilic-coated or a short sheath (control group). Primary end point was the occurrence of a radial spasm defined by significant patient pain evaluated by scale score (>4) or significant catheter frictions during manipulation. Procedure failure, radial occlusion, and local complications were also assessed.


RESULTS
Radial spasm was significantly reduced when using the long-coated compared to the short sheath in 7 (4%) vs. 32 pts (18%) P < 0.001. No difference was found regarding procedure failure respectively 1.2% vs. 0.6%, local complication 0.6% vs. 1.2%, and radial occlusion 3.5% vs. 3.5%.


CONCLUSIONS
Radial artery protection using the long hydrophilic-coated sheath was efficient in the prevention of radial spasm for transradial approach. © 2010 Wiley-Liss, Inc.
Caussin
Christophe
C
Hôpital Marie Lannelongue, Le Plessis Robinson, France. c.caussin@ccml.fr
Gharbi
Mostari
M
Durier
Chloé
C
Ghostine
Saïd
S
Pesenti-Rossi
David
D
Rahal
Saliha
S
Brenot
Philippe
P
Barri
Maruan
M
Durup
Florence
F
Lancelin
Bernard
B
D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000295:instrumentation; D001157:Arterial Occlusive Diseases / Q000209:etiology / Q000517:prevention & control*; D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000295:instrumentation; D016009:Chi-Square Distribution; D017023:Coronary Angiography / Q000009:adverse effects* / Q000295:instrumentation; D004867:Equipment Design; D005260:Female; D005602:France; D017276:Friction; D006801:Humans; D008297:Male; D008875:Middle Aged; D010146:Pain / Q000209:etiology / Q000517:prevention & control; D010147:Pain Measurement; D011677:Punctures; D017534:Radial Artery; D018570:Risk Assessment; D012307:Risk Factors; D013035:Spasm / Q000209:etiology / Q000517:prevention & control*