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Effect of transdermally applied nitroglycerin or lidocaine before transradial coronary angiography on procedure success and complications

Year 2024, EARLY ONLINE, 1 - 7
https://doi.org/10.18621/eurj.1480019

Abstract

Objective: We investigated the effect of transdermal nitroglycerin or lidocaine application on puncture time, number, and complications in patients who underwent transradial coronary angiography.

Methods: Patients with topical saline applied to the radial artery before the procedure were designated as Group 1 (n=59), those with topical nitrate were designated as Group 2 (n=43), and those with topical lidocaine were designated as Group 3 (n=40). The groups' puncture time, number, and complication rates were compared.

Results: While our average puncture time was 142±122 seconds in all patients, this time was measured as 171±131 seconds in Group 1, 88±48 seconds in Group 2, and 157±146 seconds in Group 3 (P=0.021). During the procedure, radial artery spasm was observed in 15.2% of patients in Group 1, 6.9% in Group 2, and 12.5% in Group 3 (P=0.043). Radial artery occlusion was seen in 8% of patients in Group 1, and 2.5% in Group 3, while it was not observed at all in the nitrate-applied group (P=0.041).

Conclusion: The topical application of nitroglycerin before transradial angiography is a feasible strategy to reduce radial puncture time and number, facilitate trans-radial catheterization, and decrease the incidence of radial artery spasm and occlusion.

Ethical Statement

Tekirdağ Namık Kemal University Ethics Committee

Project Number

2020.36.02.14

References

  • 1. Dal Molin A, Faggiano F, Bertoncini F, et al. Bed rest for preventing complications after transfemoral cardiac catheterisation: a protocol of systematic review and network meta-analysis. Syst Rev. 2015;4:47. doi: 10.1186/s13643-015-0036-0.
  • 2. Neumann FJ, Sousa-Uva M, Ahlsson A, et al; ESC Scientific Document Group. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J. 2019;40(2):87-165. doi: 10.1093/eurheartj/ehy394.
  • 3. Ahsan MJ, Ahmad S, Latif A, et al. Transradial versus transfemoral approach for percutaneous coronary intervention in patients with ST-elevation myocardial infarction complicated by cardiogenic shock: a systematic review and meta-analysis. Eur Heart J Qual Care Clin Outcomes. 2022;8(6):640-650. doi: 10.1093/ehjqcco/qcac018.
  • 4. Morton J, Kern Paul Sorajja, Michael J. Lim 4th Edition. The Interventional Cardiac Catheterization Handbook. Philadelphia: Elsevier, 2018.
  • 5. Khan MZ, Patel K, Franklin S, Faruqi A, Ahmad W, Saeed J. Radial artery spasm: reviews and updates. Ir J Med Sci. 2020;189(4):1253-1258. doi: 10.1007/s11845-020-02203-9.
  • 6. Beyer AT, Ng R, Singh A, et al. Topical nitroglycerin and lidocaine to dilate the radial artery prior to transradial cardiac catheterization: a randomized, placebo-controlled, double-blind clinical trial: the PRE-DILATE Study. Int J Cardiol. 2013;168(3):2575-2578. doi: 10.1016/j.ijcard.2013.03.048.
  • 7. Roghani F, Shirani B, Hashemifard O. The effect of low dose versus standard dose of arterial heparin on vascular complications following transradial coronary angiography: Randomized controlled clinical trial. ARYA Atheroscler. 2016;12(1):10-17.
  • 8. Dharma S, Kedev S, Patel T, Kiemeneij F, Gilchrist IC. A novel approach to reduce radial artery occlusion after transradial catheterization: postprocedural/prehemostasis intra-arterial nitroglycerin. Catheter Cardiovasc Interv. 2015;85(5):818-825. doi: 10.1002/ccd.25661.
  • 9. da Silva RL, Dangas GD, de Andrade PB, et al. Effect of randomized prophylactic nitroglycerin on radial artery spasm during transradial catheterization: An analysis based on operator experience. Catheter Cardiovasc Interv. 2023 Feb;101(3):579-586. doi: 10.1002/ccd.30541.
  • 10. Coroleu S, Allín J, Migliaro G, Leiva G, Baglioni P, Nogués I. Use of subcutaneous nitroglycerin to facilitate transradial access in coronary procedures (NiSAR study). REC Interv Cardiol. 2021;3(1):26-32. doi: 10.24875/RECICE.M20000141.
Year 2024, EARLY ONLINE, 1 - 7
https://doi.org/10.18621/eurj.1480019

Abstract

Project Number

2020.36.02.14

References

  • 1. Dal Molin A, Faggiano F, Bertoncini F, et al. Bed rest for preventing complications after transfemoral cardiac catheterisation: a protocol of systematic review and network meta-analysis. Syst Rev. 2015;4:47. doi: 10.1186/s13643-015-0036-0.
  • 2. Neumann FJ, Sousa-Uva M, Ahlsson A, et al; ESC Scientific Document Group. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J. 2019;40(2):87-165. doi: 10.1093/eurheartj/ehy394.
  • 3. Ahsan MJ, Ahmad S, Latif A, et al. Transradial versus transfemoral approach for percutaneous coronary intervention in patients with ST-elevation myocardial infarction complicated by cardiogenic shock: a systematic review and meta-analysis. Eur Heart J Qual Care Clin Outcomes. 2022;8(6):640-650. doi: 10.1093/ehjqcco/qcac018.
  • 4. Morton J, Kern Paul Sorajja, Michael J. Lim 4th Edition. The Interventional Cardiac Catheterization Handbook. Philadelphia: Elsevier, 2018.
  • 5. Khan MZ, Patel K, Franklin S, Faruqi A, Ahmad W, Saeed J. Radial artery spasm: reviews and updates. Ir J Med Sci. 2020;189(4):1253-1258. doi: 10.1007/s11845-020-02203-9.
  • 6. Beyer AT, Ng R, Singh A, et al. Topical nitroglycerin and lidocaine to dilate the radial artery prior to transradial cardiac catheterization: a randomized, placebo-controlled, double-blind clinical trial: the PRE-DILATE Study. Int J Cardiol. 2013;168(3):2575-2578. doi: 10.1016/j.ijcard.2013.03.048.
  • 7. Roghani F, Shirani B, Hashemifard O. The effect of low dose versus standard dose of arterial heparin on vascular complications following transradial coronary angiography: Randomized controlled clinical trial. ARYA Atheroscler. 2016;12(1):10-17.
  • 8. Dharma S, Kedev S, Patel T, Kiemeneij F, Gilchrist IC. A novel approach to reduce radial artery occlusion after transradial catheterization: postprocedural/prehemostasis intra-arterial nitroglycerin. Catheter Cardiovasc Interv. 2015;85(5):818-825. doi: 10.1002/ccd.25661.
  • 9. da Silva RL, Dangas GD, de Andrade PB, et al. Effect of randomized prophylactic nitroglycerin on radial artery spasm during transradial catheterization: An analysis based on operator experience. Catheter Cardiovasc Interv. 2023 Feb;101(3):579-586. doi: 10.1002/ccd.30541.
  • 10. Coroleu S, Allín J, Migliaro G, Leiva G, Baglioni P, Nogués I. Use of subcutaneous nitroglycerin to facilitate transradial access in coronary procedures (NiSAR study). REC Interv Cardiol. 2021;3(1):26-32. doi: 10.24875/RECICE.M20000141.
There are 10 citations in total.

Details

Primary Language English
Subjects Cardiology
Journal Section Original Articles
Authors

Nurullah Uslu 0000-0002-3152-8292

Cihan Aydın 0000-0002-1401-5727

Aykut Demirkıran 0000-0001-8322-3514

Hüseyin Aykaç 0000-0003-4374-5603

Şeref Alpsoy 0000-0003-3720-0076

Project Number 2020.36.02.14
Early Pub Date July 17, 2024
Publication Date
Submission Date May 7, 2024
Acceptance Date June 13, 2024
Published in Issue Year 2024 EARLY ONLINE

Cite

AMA Uslu N, Aydın C, Demirkıran A, Aykaç H, Alpsoy Ş. Effect of transdermally applied nitroglycerin or lidocaine before transradial coronary angiography on procedure success and complications. Eur Res J. Published online July 1, 2024:1-7. doi:10.18621/eurj.1480019

e-ISSN: 2149-3189 


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