Should We Use a Staged or Ad hoc Approach in Percutaneous Coronary Interventions Through the Radial Artery to Avoid Radial Artery Spasm?

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Erciyes Medical Journal, vol.42, no.2, pp.139-142, 2020 (ESCI) identifier identifier

  • Publication Type: Article / Article
  • Volume: 42 Issue: 2
  • Publication Date: 2020
  • Doi Number: 10.14744/etd.2020.94752
  • Journal Name: Erciyes Medical Journal
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Academic Search Premier, CAB Abstracts, EMBASE, Veterinary Science Database, Directory of Open Access Journals, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.139-142
  • Keywords: Radial artery spasm, percutaneous coronary interventions, radial access, coronary artery disease
  • Istanbul Medipol University Affiliated: Yes


Objective: Transradial approach has recently been adopted as the default strategy for percutaneous coronary interventionsdue to benefits which include reduced all-cause mortality, major access-site complications, and hospital stay, as well asincreased patient comfort and early ambulation. However, radial artery spasm (RAS) is still a major drawback. The impacton RAS of an ad hoc compared with a staged intervention strategy has not previously been investigated. In this study, wesought to investigate the effect of ad hoc and staged percutaneous coronary intervention (PCI) on RAS in patients undergoingelective transradial coronary interventions.Materials and Methods: In this retrospective study, patients with symptoms suggestive of ischemia who were scheduledfor coronary angiography and candidates for elective PCI were enrolled and divided into two equal groups: ad hoc groupand staged group. RAS was clinically identified and established based on the existence of two or more of predefinedclinical features.Results: A total of 60 patients was enrolled in the study: 30 in the ad hoc group and 30 in the staged group. The mean timebetween coronary angiography and intervention in the staged group was 2.5 [1–30] days. RAS rates were similar betweenthe ad hoc and staged PCI groups (16.7% [n=5] vs. 31% [n=9], p=0.233), but post-procedural pain was more frequent inpatients in the ad hoc group (64.5% [n=20] vs. 33.3% [n=10], p=0.021). Radial artery occlusion did not differ between thead hoc and staged PCI groups (10.7 % [n=3] vs. 11.1 [n=3], p=1).Conclusion: Use of ad hoc or staged strategies in patients undergoing transradial PCIs is not associated with reduced incidence of RAS. Post-procedural pain is more common in patients undergoing ad hoc PCI through radial artery.