title: Time-course of vascular dysfunction of brachial artery after transradial access for coronary angiography.
abstract: BACKGROUND
  Prior studies have demonstrated endothelial and smooth muscle brachial artery dysfunction after transradial cardiac catheterization for diagnostic coronary angiography. The duration of this vascular dysfunction is unknown.
  
  
  OBJECTIVE
  To determine the time-course of endothelial and smooth muscle cell dysfunction in the upstream brachial artery after transradial cardiac catheterization.
  
  
  METHODS
  We studied 22 consecutive patients with suspected coronary artery disease (age 64.4 ± 7.7 years) undergoing diagnostic transradial cardiac catheterization. Using high-resolution vascular ultrasound, we measured ipsilateral brachial artery diameter changes during reactive hyperemia (endothelium-dependent dilatation) and administration of sublingual nitroglycerin (endothelium-independent dilatation). The measurements were taken at baseline (before cardiac catheterization), 6 h, 24 h, 1 week, and 1 month postprocedure. The contralateral brachial artery served as a control.
  
  
  RESULTS
  Ipsilateral brachial artery diameter during endothelium-dependent dilatation decreased significantly compared with the contralateral diameters at 6 h and 24 h after transradial cardiac catheterization (3.22 vs. 4.11 and 3.29 vs. 4.11, respectively, P < 0.001). The administration of nitroglycerin did not affect this difference. At 1 week and 1 month postprocedure there was no significant difference in diameter of the ipsilateral versus the contralateral brachial artery. As expected the contralateral brachial artery showed no significant changes in diameter.
  
  
  CONCLUSIONS
  Our results showed that transradial cardiac catheterization causes transient vascular endothelial and smooth muscle dysfunction of the ipsilateral brachial artery, which resolves within 1 week postprocedure. These findings strongly suggest the absence of systemic vascular dysfunction after transradial catheterization both immediately postprocedure as well as 1 week postprocedure. © 2015 Wiley Periodicals, Inc.
authors.affiliation: Department of Medicine, Division of Cardiology, Montefiore Medical Center, The University Hospital for the Albert Einstein College of Medicine, Bronx, New York.
authors.forename: Jerson
authors.initials: J
authors.lastname: Munoz-Mendoza
authors.affiliation: Department of Medicine, Division of Cardiology, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Abhijit
authors.initials: A
authors.lastname: Ghatak
authors.affiliation: Department of Medicine, University of Miami/Jackson Memorial Hospital, Miami, Florida.
authors.forename: Veronica
authors.initials: V
authors.lastname: Pinto Miranda
authors.affiliation: Department of Medicine, University of Miami/Jackson Memorial Hospital, Miami, Florida.
authors.forename: Shaka
authors.initials: S
authors.lastname: Bahadu
authors.affiliation: Department of Medicine, Division of Cardiology, University of Miami Miller School of Medicine, Miami, Florida.
authors.forename: Eduardo
authors.initials: E
authors.lastname: De Marchena
authors.affiliation: Department of Medicine, Division of Cardiology, University of Miami Miller School of Medicine, Miami, Florida.|Cardiovascular Division, Jackson Memorial Hospital, Miami, Florida.
authors.forename: Alexandre C
authors.initials: AC
authors.lastname: Ferreira
authors.affiliation: Cardiovascular Division, Jackson Memorial Hospital, Miami, Florida.
authors.forename: Cesar E
authors.initials: CE
authors.lastname: Mendoza
mesh_terms: D001916:Brachial Artery / Q000503:physiopathology*; D006328:Cardiac Catheterization / Q000379:methods*; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000175:diagnosis* / Q000503:physiopathology; D004730:Endothelium, Vascular / Q000503:physiopathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D017534:Radial Artery; D013997:Time Factors; D014664:Vasodilation / Q000502:physiology*
keywords: cardiac catheterization; peripheral catheterization; radial artery; vascular injuries