Effect of randomized prophylactic nitroglycerin on radial artery spasm during transradial catheterization: An analysis based on operator experience

Roberto L. da Silva, George D. Dangas, Pedro B. de Andrade, Rodrigo M. Joaquim, Thais R.W. da Silva, Tammuz Fattah, Vanderlei C. Pereira, Ricardo A. Zanella, Amanda G.M. Sousa, Fausto Feres, José R. Costa

Research output: Contribution to journalArticlepeer-review

1 Scopus citations

Abstract

One limitation to transradial access (TRA) is the occurrence of spasms (RAS), for which the use of prophylactic medications is recommended. Improvement in TRA material combined with the increase in operators' expertise, might mitigate this benefit. We assess the effect of preventive nitroglycerin on RAS during TRA, evaluating the role of the operator's experience. Patients received 500 μg nitroglycerin or placebo. The operator's expertise was classified as: inexperienced (I), intermediate (M), and experienced (E). 2040 patients were included. Prophylactic use of nitroglycerin did not reduce RAS (10.8% vs. 13.4% (placebo), p = 0.07). RAS incidence was 14.5% in I, 12.5% in M, and 9.7% in E (p = 0.01). In group I, nitroglycerin reduced RAS (17.4% vs. 11.1%, p = 0.04), which was not observed in other groups. Overall, nitroglycerin does not prevent RAS, which is more common among inexperienced operators. More experienced operators could abolish preventive nitroglycerin use.

Original languageEnglish
Pages (from-to)579-586
Number of pages8
JournalCatheterization and Cardiovascular Interventions
Volume101
Issue number3
DOIs
StatePublished - 15 Feb 2023

Keywords

  • nitroglycerin
  • radial artery spasm
  • transradial catheterization

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