title: Brewing the right cocktail for radial intervention.
abstract: Radial access angioplasty has increased in popularity worldwide due to its decrease of access site complications, early patient mobility, patient comfort and lower costs. In a minority of patients, radial artery occlusion and radial artery spasm occurs. Because of the dual blood supply to the hand, radial artery occlusion is not associated with major clinical sequelae but prevention is important. Radial artery spasm rarely leads to serious vascular complications but can cause patient discomfort and can result in prolonging or failure of the procedure. Pharmacological and non-pharmacological strategies have been evaluated to prevent radial artery occlusion and radial artery spasm. A number of pharmacological 'cocktails' have been successfully tested but there is currently no agreement on the optimal combination of agents. In order to evaluate the best strategy to prevent radial artery occlusion and radial artery spasm we reviewed the relevant studies to date. From these studies it is clear that a 'cocktail' of agents should be given before transradial coronary angiography or angioplasty. A combination of heparin, nitroglycerin and verapamil is associated with the best preventive outcome.
authors.affiliation: Victoria Heart Institute, Victoria, British Columbia, Canada. tvuurmans@vhif.org
authors.forename: Tycho
authors.initials: T
authors.lastname: Vuurmans
authors.forename: David
authors.initials: D
authors.lastname: Hilton
mesh_terms: D000317:Adrenergic alpha-Antagonists / Q000627:therapeutic use; D015906:Angioplasty, Balloon, Coronary; D000925:Anticoagulants / Q000627:therapeutic use*; D001157:Arterial Occlusive Diseases / Q000209:etiology* / Q000517:prevention & control*; D002121:Calcium Channel Blockers / Q000627:therapeutic use; D006328:Cardiac Catheterization / Q000379:methods*; D002406:Catheterization, Peripheral / Q000379:methods*; D004359:Drug Therapy, Combination; D006493:Heparin / Q000627:therapeutic use*; D006801:Humans; D008278:Magnesium Sulfate / Q000627:therapeutic use; D005996:Nitroglycerin / Q000627:therapeutic use*; D016491:Peripheral Vascular Diseases / Q000209:etiology* / Q000517:prevention & control*; D017534:Radial Artery; D014665:Vasodilator Agents / Q000627:therapeutic use*; D014700:Verapamil / Q000627:therapeutic use*
chemical_list: D000317:Adrenergic alpha-Antagonists; D000925:Anticoagulants; D002121:Calcium Channel Blockers; D014665:Vasodilator Agents; D008278:Magnesium Sulfate; D006493:Heparin; D014700:Verapamil; D005996:Nitroglycerin