The Effect of New 5 F "Terumo Glidesheath Slender" Arterial Sheath on Radial Artery Spasm

Abstract

Aim: During transradial approach, various size and brand arterial sheaths are used. Furthermore, the most important limitation of the tranradial approach is the spasm that occurs during the process. In this study, the effect of hydrophilic coating and length of arterial sheath used on the development of radial artery spasm was investigated. Method: A total of 74 patients (38 females, 36 males) were included in the study. The mean age was 59.2 ± 1.1 years and the body mass index was 31.4 ± 1.0. 5 F "Terumo Glidesheath Slender" 16 cm arterial sheath used group 1 and 5 F "Terumo Radiofocus Intraducer II Sheath" 7 cm arterial sheath used group 2. Both arterial sheaths were used consecutively. 5F Terumo Radiofocus Optitorque Radial TIG II 3.5 and 4.0 catheters were used for coronary angiography. Both groups were compared in terms of radial arterial spasm, total procedure time, fluoroscopy time, and amount of contrast used. Results: Both groups were similar in terms of gender (p = 0.16), body mass index (p = 0.35), diabetes mellitus (p = 0.96), hypertension (p = 0.43), and hyperlipidemia (p = 0.42). In Group 1, total procedure time and fluoroscopy time were longer, total radiation amount and contrast medium amount were higher, but this difference was not significant. Spasm limiting the procedure occurred in one patient in each group. 2 (6%) patients in Group 1 and 17 (41%) patients in Group 2 had spasm that did not limit the procedure (p = 0.02). Conclusion: In our study, 5 F "Terumo Glidesheath Slender" 16 cm arterial sheat cause less radial artery spasm than 5 F "Terumo Radiofocus Intraducer II Sheath" 7 arterial sheat.

Keywords

• Koroner Anjiyografi,Terumo Glidesheath Slender,Radial Arter Spazm,Transradial

Yeni 5 F "Terumo Glidesheath Slender" Arterial Kılıfın Radial Arter Spazmı Üzerine Etkisi

Abstract

Amaç: Transradaial girişim sırasında çeşitli size ve marka arterial kılıflar kullanılmaktadır. Ayrıca tranradial işlemin en önmeli sınırlayıcısı işlem sırasında ortaya çıkan spazmdır. Çalışmamızda kullanılan arterial kılıfın hidrofilik oluşu ve uzunluğunun radial arter spazmı gelişimi üzerine etkisi araştırılmıştır. Metod: Çalışmaya toplam 74 hasta (38 kadın, 36 erkek) alındı. Ortalama yaş 59.2 ± 1.1, vücut kitle indeksi 31.4±1.0 idi. 5 F "Terumo Glidesheath Slender" 16 cm arterial kılıf kullanılan grup 1 ile 5 F "Terumo Radiofocus Intraducer II Sheath" 7 cm arterial kılıf kullanılan grup 2 sınıflandırıldı. Her iki arterial kılıf ardışık olarak kullanıldı. Koroner anjiyografi işlemi için 5F Terumo Radiofocus Optitorque Radial TIG II 3.5 ve 4.0 kateter kullanıldı. Her iki grup radial arer spazmı, total işlem süresi, floroskopi süresi, kullanılan kontrast miktarı açısından karşılaştırıldı. Bulgular: Her iki grup cinsiyet (p=0.16), vücut kitle indeksi (p=0.35), diabetes mellitus (p=0.96), hipertansiyon (p=0.43), hiperlipidemi (p=0.42) sıklığı açısından benzerdi. Grup 1 de total işlem süresi ve floroskopi süresi daha uzun, total radyasyon miktarı ve kullanılan kontrast madde miktarı daha yüksek saptandı, ancak bu farklılık anlamlı düzeyde değildi. İşlemi sınırlayan spazm her iki grupta birer hastada ortaya çıktı. Grup 1 de 2 (%6) hastada Grup 2 de 17 (%41) hastada işlemi sınırlamayan spazm ortaya çıktı (p=0.02). Sonuç: Çalışmamızda 5 F "Terumo Glidesheath Slender" 16 cm sheat ile 5 F "Terumo Radiofocus Intraducer II Sheath" 7 cm sheat'e göre daha az radial arter spazmın görülmüştür.

Keywords

• ransradial,Koroner Anjiyografi,Terumo Glidesheath Slender,Radial Arter Spazm

References

1. 1. Valgimigli M, Gagnor A, Calabró P, Frigoli E, Leonardi S, Zaro T, vd. Radial versus femoral access in patients with acute coronary syndromes undergoing invasive management: a randomised multicentre trial. Lancet Lond Engl. 20 Haziran 2015;385(9986):2465-76. 2. Ziakas A, Gomma A, McDonald J, Klinke P, Hilton D. A comparison of the radial and the femoral approaches in primary or rescue percutaneous coronary intervention for acute myocardial infarction in the elderly. Acute Card Care. 2007;9(2):93-6. 3. Jolly SS, Yusuf S, Cairns J, Niemelä K, Xavier D, Widimsky P, vd. Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial. Lancet Lond Engl. 23 Nisan 2011;377(9775):1409-20. 4. Ibanez B, James S, Agewall S, Antunes MJ, Bucciarelli-Ducci C, Bueno H, vd. 2017 ESC Guidelines for the management of acute myocardial infarction in patients presenting with ST-segment elevation: The Task Force for the management of acute myocardial infarction in patients presenting with ST-segment elevation of the European Society of Cardiology (ESC). Eur Heart J. 07 2018;39(2):119-77. 5. Ball WT, Sharieff W, Jolly SS, Hong T, Kutryk MJB, Graham JJ, vd. Characterization of operator learning curve for transradial coronary interventions. Circ Cardiovasc Interv. Ağustos 2011;4(4):336-41. 6. Rathore S, Stables RH, Pauriah M, Hakeem A, Mills JD, Palmer ND, vd. Impact of length and hydrophilic coating of the introducer sheath on radial artery spasm during transradial coronary intervention: a randomized study. JACC Cardiovasc Interv. Mayıs 2010;3(5):475-83. 7. Curtis E, Fernandez R, Lee A. The effect of vasodilatory medications on radial artery spasm in patients undergoing transradial coronary artery procedures: a systematic review. JBI Database Syst Rev Implement Rep. 2017;15(7):1952-67. 8. Hizoh I, Majoros Z, Major L, Gulyas Z, Szabo G, Kerecsen G, vd. Need for prophylactic application of verapamil in transradial coronary procedures: a randomized trial. The VITRIOL (is Verapamil In TransRadial Interventions OmittabLe?) trial. J Am Heart Assoc. 14 Nisan 2014;3(2):e000588. 9. Deftereos S, Giannopoulos G, Raisakis K, Hahalis G, Kaoukis A, Kossyvakis C, vd. Moderate procedural sedation and opioid analgesia during transradial coronary interventions to prevent spasm: a prospective randomized study. JACC Cardiovasc Interv. Mart 2013;6(3):267-73. 10. Caussin C, Gharbi M, Durier C, Ghostine S, Pesenti-Rossi D, Rahal S, vd. Reduction in spasm with a long hydrophylic transradial sheath. Catheter Cardiovasc Interv Off J Soc Card Angiogr Interv. 01 Kasım 2010;76(5):668-72. 11. Campeau L. Percutaneous radial artery approach for coronary angiography. Cathet Cardiovasc Diagn. Ocak 1989;16(1):3-7. 12. Anjum I, Khan MA, Aadil M, Faraz A, Farooqui M, Hashmi A. Transradial vs. Transfemoral Approach in Cardiac Catheterization: A Literature Review. Cureus. 03 Haziran 2017;9(6):e1309. 13. Riangwiwat T, Mumtaz T, Blankenship JC. Barriers to use of radial access for percutaneous coronary intervention. Catheter Cardiovasc Interv Off J Soc Card Angiogr Interv. 04 Aralık 2019; 14. Ho HH, Jafary FH, Ong PJ. Radial artery spasm during transradial cardiac catheterization and percutaneous coronary intervention: incidence, predisposing factors, prevention, and management. Cardiovasc Revascularization Med Mol Interv. Haziran 2012;13(3):193-5. 15. Kiemeneij F, Vajifdar BU, Eccleshall SC, Laarman G, Slagboom T, van der Wieken R. Evaluation of a spasmolytic cocktail to prevent radial artery spasm during coronary procedures. Catheter Cardiovasc Interv Off J Soc Card Angiogr Interv. Mart 2003;58(3):281-4. 16. Saito S, Tanaka S, Hiroe Y, Miyashita Y, Takahashi S, Satake S, vd. Usefulness of hydrophilic coating on arterial sheath introducer in transradial coronary intervention. Catheter Cardiovasc Interv Off J Soc Card Angiogr Interv. Temmuz 2002;56(3):328-32. 17. Sindberg B, Aagren Nielsen CG, Hestbjerg Poulsen M, Bøhme Rasmussen M, Carstensen S, Thim T, vd. Randomized Comparison of Terumo® Coated SlenderTM versus Terumo® Noncoated Traditional Sheath during Radial Angiography or Percutaneous Coronary Intervention. J Intervent Cardiol. 2019;2019:7348167. 18. Rashid M, Kwok CS, Pancholy S, Chugh S, Kedev SA, Bernat I, vd. Radial Artery Occlusion After Transradial Interventions: A Systematic Review and Meta-Analysis. J Am Heart Assoc. 25 Ocak 2016;5(1). 19. Yoshimachi F, Kiemeneij F, Masutani M, Matsukage T, Takahashi A, Ikari Y. Safety and feasibility of the new 5 Fr Glidesheath Slender. Cardiovasc Interv Ther. Ocak 2016;31(1):38-41.