title: Procedural sedation during transradial coronary angiography to prevent spasm.
abstract: OBJECTIVE
  Radial artery spasm is common during transradial procedures and is the most common cause of procedural failure. The objectives of this study were to assess whether the routine administration of sedation at the beginning of transradial coronary angiography with the use of hydrophilic-coated and smaller sheaths/catheters would reduce the incidence of radial artery spasm.
  
  
  METHODS
  Patients undergoing transradial coronary angiography were prospectively randomized to receive midazolam during the procedure or no sedative treatment. The primary endpoint was angiographically confirmed radial artery spasm. Stenosis of the radial artery was measured with a computer-assisted quantification method.
  
  
  RESULTS
  In all, 150 patients were randomized into a treatment group and a control group. Spasm occurred in 15 patients of the treatment group (20 %) versus 16 in the control group (21.3 %). There were no differences between the two groups regarding the incidence of spasm and the distribution of spasm severity (p > 0.05). No significant differences were observed between the two groups in terms of 30-day mortality or repeat hospitalization for any cause (p > 0.05).
  
  
  CONCLUSIONS
  Routine use of midazolam could not reduce the occurrence of radial artery spasm during transradial coronary angiography.
authors.affiliation: Department of Cardiology, Evliya Celebi Training and Research Hospital, Kutahya, Turkey. maliastarcioglu@hotmail.com.
authors.forename: M A
authors.initials: MA
authors.lastname: Astarcioglu
authors.affiliation: Department of Cardiology, Evliya Celebi Training and Research Hospital, Kutahya, Turkey.
authors.forename: T
authors.initials: T
authors.lastname: Sen
authors.affiliation: Department of Cardiology, Dumlupinar University, Kutahya, Turkey.
authors.forename: C
authors.initials: C
authors.lastname: Kilit
authors.affiliation: Department of Cardiology, Evliya Celebi Training and Research Hospital, Kutahya, Turkey.
authors.forename: H I
authors.initials: HI
authors.lastname: Durmus
authors.affiliation: Department of Cardiology, Malatya State Hospital, Malatya, Turkey.
authors.forename: G
authors.initials: G
authors.lastname: Gozubuyuk
authors.affiliation: Department of Cardiology, Kosuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey.
authors.forename: H Z
authors.initials: HZ
authors.lastname: Agus
authors.affiliation: Department of Cardiology, Kosuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Kalcik
authors.affiliation: , Kars, Turkey.
authors.forename: S
authors.initials: S
authors.lastname: Karakoyun
authors.affiliation: Department of Cardiology, Kosuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Yesin
authors.affiliation: Department of Cardiology, Dumlupinar University, Kutahya, Turkey.
authors.forename: A
authors.initials: A
authors.lastname: Dogan
authors.affiliation: Department of Cardiology, Kosuyolu Kartal Heart Training and Research Hospital, Istanbul, Turkey.
authors.forename: M
authors.initials: M
authors.lastname: Ozkan
mesh_terms: D002406:Catheterization, Peripheral / Q000009:adverse effects* / Q000379:methods; D016292:Procedural Sedation / Q000379:methods*; D017023:Coronary Angiography / Q000009:adverse effects* / Q000379:methods; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging* / Q000628:therapy; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage; D008297:Male; D008874:Midazolam / Q000008:administration & dosage; D008875:Middle Aged; D017534:Radial Artery / Q000187:drug effects*; D011856:Radiographic Image Enhancement / Q000379:methods; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013035:Spasm / Q000209:etiology / Q000517:prevention & control*; D016896:Treatment Outcome
chemical_list: D006993:Hypnotics and Sedatives; D008874:Midazolam
keywords: Coronary angiography; Coronary catheterization; Midazolam; Radial artery spasm; Sedation