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Prevention of arterial spasm during percutaneous coronary interventions through radial artery: The SPASM study
Author(s) -
Varenne Olivier,
Jégou Arnaud,
Cohen Remy,
Empana Jean Philippe,
Salengro Emmanuel,
Ohanessian Alice,
Gaultier Cédric,
Allouch Philippe,
Walspurger Sylvie,
Margot Olivier,
El Hallack Abdel,
Jouven Xavier,
Weber Simon,
Spaulding Christian
Publication year - 2006
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.20812
Subject(s) - medicine , molsidomine , radial artery , verapamil , percutaneous , cardiology , anesthesia , artery , placebo , nitric oxide , alternative medicine , pathology , calcium
Aims : Radial artery spasm remains the major limitation of transradial approach for percutaneous coronary interventions. The aim of our study was to evaluate the efficacy of vasodilators in the prevention of radial artery spasm during percutaneous coronary interventions. Methods and results : 1,219 patients were consecutively randomized to receive placebo ( n = 198), molsidomine 1 mg ( n = 203), verapamil 2.5 mg ( n = 409), 5 mg ( n = 203) or verapamil 2.5 mg and molsidomine 1 mg ( n = 206). All drugs were administered through the arterial sheath. The primary end point was the occurrence of a radial artery spasm defined by the operator as severe limitation of the catheter movement, with or without angiographic confirmation. Main characteristics including age, sex, wrist and arterial sheath diameters and procedure duration were identical across the groups. The rate of radial artery spasm was lowest in patients receiving verapamil and molsidomine (4.9%), compared to verapamil 2.5 mg or 5 mg (8.3 and 7.9%), or molsidomine 1 mg (13.3%); and placebo (22.2%) ( P < 0.0001). Conclusion : Radial artery spasm during transradial percutaneous interventions was effectively prevented by the administration of vasodilators. The combination of verapamil 2.5 mg and molsidomine 1 mg provided the strongest relative risk reduction of spasm compared to placebo and should therefore be recommended during percutaneous coronary interventions through the radial approach. © 2006 Wiley‐Liss, Inc.