title: Assessment of vascular dysfunction after transradial coronary angiography. Is a single catheter better?
abstract: BACKGROUND
  The aim of this study was to investigate the midterm effects of transradial coronary angiography (TRCAG) on the radial and brachial artery diameter, the vasodilator characteristics, as well as to assess the factors determining functional recovery.
  
  
  METHODS
  This study included 136 consecutive patients who underwent TRCAG. The radial artery was evaluated with ultrasonography before and 1 month after the procedure.
  
  
  RESULTS
  The basal right radial artery diameter (2.97 ± 0.46 vs. 2.82 ± 0.51, p < 0.001), after flow-mediated dilatation (FMD; 3.18 ± 0.45 vs. 2.99 ± 0.54, p < 0.001) and after nitroglycerin-mediated dilatation (NMD; 3.32 ± 0.45 vs. 3.11 ± 0.54, p < 0.001), and the percentage change in diameter after FMD (7.50 ± 3.62 vs. 5.89 ± 3.04, p < 0.001) and NMD (12.42 ± 4.96 vs. 10.54 ± 4.47, p < 0.001) were significantly decreased 1 month after TRCAG. The mean basal diameter of the right brachial artery (4.41 ± 0.58 vs. 4.40 ± 0.58, p = 0.012) after FMD (4.61 ± 0.60 vs. 4.59 ± 0.59, p < 0.001) and the percentage change in diameter after FMD (4.53 ± 2.29 vs. 4.33 ± 2.56, p = 0.038) were significantly decreased 1 month after TRCAG. The number of catheters used (B = 0.372, p < 0.001, 95 % CI = 0.006-0.013), basal radial artery diameter (B = - 0.217, p = 0.001, 95 % CI = - 0.021- 0.006), presence of hypertension (B = - 0.151, p = 0.011, 95 % CI = - 0.015 - 0.002), and pain score (B = 0.493, p < 0.001, 95 % CI = 0.007 - 0.012) were independent predictors of radial artery FMD change in multivariate regression analysis. The number of catheters used (B = 0.378, p < 0.001, 95 % CI = 0.009 - 0.020), basal radial artery diameter (B = - 0.210, p = 0.010, 95 % CI = - 0.034 - 0.005), and pain score (B = 0.221, p < 0.001, 95 % CI = 0.002-0.011) were independent predictors of radial artery NMD change in multivariate regression analysis.
  
  
  CONCLUSIONS
  Basal radial artery diameter, the number of catheters used during TRCAG, and the pain perceived during the procedure seem to be important predictors of vascular functional changes after TRCAG.
authors.affiliation: Department of Cardiology, Ahi Evren Chest Cardiovascular Surgery Education and Research Hospital, Soğuksu Mah, Çamlık Street, 61040, Trabzon, Turkey. ahmetaykan@yahoo.com.
authors.forename: Ahmet Çağrı
authors.initials: AÇ
authors.lastname: Aykan
authors.affiliation: Department of Cardiology, Ahi Evren Chest Cardiovascular Surgery Education and Research Hospital, Soğuksu Mah, Çamlık Street, 61040, Trabzon, Turkey.
authors.forename: Ezgi
authors.initials: E
authors.lastname: Kalaycıoğlu
authors.affiliation: Department of Cardiology, Ahi Evren Chest Cardiovascular Surgery Education and Research Hospital, Soğuksu Mah, Çamlık Street, 61040, Trabzon, Turkey.
authors.forename: Tayyar
authors.initials: T
authors.lastname: Gökdeniz
authors.affiliation: Department of Pharmacology, Karadeniz Technic University Faculty of Medicine, Trabzon, Turkey.
authors.forename: Duygun Altıntaş
authors.initials: DA
authors.lastname: Aykan
authors.affiliation: Department of Cardiology, Ahi Evren Chest Cardiovascular Surgery Education and Research Hospital, Soğuksu Mah, Çamlık Street, 61040, Trabzon, Turkey.
authors.forename: Engin
authors.initials: E
authors.lastname: Hatem
authors.affiliation: Department of Cardiology, Siyami Ersek Education and Research Hospital, Istanbul, Turkey.
authors.forename: Regayip
authors.initials: R
authors.lastname: Zehir
mesh_terms: D006328:Cardiac Catheterization / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D002406:Catheterization, Peripheral / Q000009:adverse effects*; D017023:Coronary Angiography / Q000009:adverse effects* / Q000295:instrumentation / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D058729:Peripheral Arterial Disease / Q000000981:diagnostic imaging* / Q000209:etiology*; D017534:Radial Artery / Q000000981:diagnostic imaging; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D014463:Ultrasonography
keywords: Angiography; Brachial artery; Flow-mediated dilatation; Radial artery; Vascular