title: Efficacy and safety of nitroglycerin for preventing venous spasm during contrast-guided axillary vein puncture for pacemaker or defibrillator leads implantation.
abstract: OBJECTIVE
  We investigated the efficacy and safety of nitroglycerin for preventing venous spasm during contrast-guided axillary vein puncture for pacemaker or defibrillator leads implantation.
  
  
  RESULTS
  A total of 40 consecutive patients referred for contrast-guided axillary vein puncture for pacemaker or defibrillator implantations were included in the study. Patients were randomly assigned to control group and nitroglycerin group. Patients in the nitroglycerin group were given 200 µg (2 mL) nitroglycerin via ipsilateral peripheral vein about 3 min before puncture. The degree of venous spasm was evaluated by the reduction in lumen calibre of the axillary vein after puncture. Mild venous spasm and severe venous spasm were defined as a reduction in lumen calibre of 50-90% and ≥ 90%, respectively. The mean degree of venous spasm of axillary vein was lower in the nitroglycerin group than in the control group (23.0 ± 22.3 vs. 45.5 ± 33.6%, P = 0.018). The incidence of mild or severe venous spasm was lower in the nitroglycerin group than in the control group (3/20 vs. 11/20, P = 0.019). In the nitroglycerin group, the systolic blood pressure had a significant decrease after puncture (129.5 ± 23.7 vs. 143.0 ± 24.1 mmHg, P = 0.003). There was no hypotension and other adverse reaction of nitroglycerin in the nitroglycerin group.
  
  
  CONCLUSIONS
  Intravenous nitroglycerin is effective and safe for preventing venous spasm during contrast-guided axillary vein puncture for pacemaker or defibrillator leads implantation.
authors: Department of Cardiology, The First People's Hospital of Hangzhou, 261# Huansha Road, Hangzhou 310000, China. duanxu410@yahoo.com.cn
authors: Xu
authors: X
authors: Duan
authors: Feng
authors: F
authors: Ling
authors: Yun
authors: Y
authors: Shen
authors: Jun
authors: J
authors: Yang
authors: Hai-ying
authors: HY
authors: Xu
authors: Xiao-shan
authors: XS
authors: Tong
mesh_terms: D061605:Administration, Intravenous; D000368:Aged; D000369:Aged, 80 and over; D001367:Axillary Vein / Q000000981:diagnostic imaging; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D002681:China / Q000453:epidemiology; D003251:Constriction, Pathologic; D003287:Contrast Media; D017147:Defibrillators, Implantable; D005260:Female; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D005996:Nitroglycerin / Q000008:administration & dosage* / Q000009:adverse effects; D010138:Pacemaker, Artificial; D010690:Phlebography; D019919:Prosthesis Implantation / Q000295:instrumentation*; D011677:Punctures; D015641:Radiography, Interventional; D016896:Treatment Outcome; D014652:Vascular Diseases / Q000453:epidemiology / Q000517:prevention & control*; D014665:Vasodilator Agents / Q000008:administration & dosage* / Q000009:adverse effects
chemical_list: D003287:Contrast Media; D014665:Vasodilator Agents; D005996:Nitroglycerin