Radial artery spasms – angiographic morphology, risk
factors and management

Jan Roczniak; Andrzej Tarnawski; Artur Dziewierz; Szymon Glanowski; Artur Pawlik; Karol Sabatowski; Rafał Januszek; Łukasz Rzeszutko; Andrzej Surdacki; Stanisław Bartuś; Michał Chyrchel

doi:10.5114/aic.2024.136936

eISSN: 1897-4295
ISSN: 1734-9338

Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej

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abstract:

Original paper

Radial artery spasms – angiographic morphology, risk factors and management

Jan Roczniak

¹

,

Andrzej Tarnawski

²

,

Artur Dziewierz

^{1, 3}

,

Szymon Glanowski

⁴

,

Artur Pawlik

¹

,

Karol Sabatowski

¹

,

Rafał Januszek

⁵

,

Łukasz Rzeszutko

^{1, 3}

,

Andrzej Surdacki

^{1, 3}

,

Stanisław Bartuś

^{1, 3}

,

Michał Chyrchel

^{1, 3}

Department of Cardiology and Cardiovascular Interventions, University Hospital, Krakow, Poland
University of California, Irvine, USA
Second Department of Cardiology, Faculty of Medicine, Institute of Cardiology, Jagiellonian University Medical College, Krakow, Poland
Students’ Scientific Group at the Second Department of Cardiology, Jagiellonian University Medical College, Krakow, Poland
Faculty of Medicine and Health Sciences, Andrzej Frycz Modrzewski Cracow University, Krakow, Poland

Adv Interv Cardiol 2024; 20, 1 (75): 53–61

DOI: https://doi.org/10.5114/aic.2024.136936

Online publish date: 2024/03/22

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AMA

Roczniak J, Tarnawski A, Dziewierz A, et al. Radial artery spasms – angiographic morphology, risk
factors and management. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2024;20(1):53-61. doi:10.5114/aic.2024.136936.

APA

Roczniak, J., Tarnawski, A., Dziewierz, A., Glanowski, S., Pawlik, A.,  & Sabatowski, K. et al. (2024). Radial artery spasms – angiographic morphology, risk
factors and management. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 20(1), 53-61. https://doi.org/10.5114/aic.2024.136936

Chicago

Roczniak, Jan, Andrzej Tarnawski, Artur Dziewierz, Szymon Glanowski, Artur Pawlik, Karol Sabatowski,  and Rafał Januszek et al. 2024. "Radial artery spasms – angiographic morphology, risk
factors and management". Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej 20 (1): 53-61. doi:10.5114/aic.2024.136936.

Harvard

Roczniak, J., Tarnawski, A., Dziewierz, A., Glanowski, S., Pawlik, A., Sabatowski, K., Januszek, R., Rzeszutko, Ł., Surdacki, A., Bartuś, S.,  and Chyrchel, M. (2024). Radial artery spasms – angiographic morphology, risk
factors and management. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, 20(1), pp.53-61. https://doi.org/10.5114/aic.2024.136936

MLA

Roczniak, Jan et al. "Radial artery spasms – angiographic morphology, risk
factors and management." Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej, vol. 20, no. 1, 2024, pp. 53-61. doi:10.5114/aic.2024.136936.

Vancouver

Roczniak J, Tarnawski A, Dziewierz A, Glanowski S, Pawlik A, Sabatowski K et al. Radial artery spasms – angiographic morphology, risk
factors and management. Advances in Interventional Cardiology/Postępy w Kardiologii Interwencyjnej. 2024;20(1):53-61. doi:10.5114/aic.2024.136936.

Introduction:
Radial artery is the preferred access for coronary interventions. However, the procedure is sometimes interrupted by a spasm which causes pain, prolongs the procedure, and can force the access crossover.

Aim:
To observe factors contributing to a symptomatic radial artery spasm.

Material and methods:
In this prospective study, we present results of 103 consecutive patients regarding radial artery spasm and angiographic image of the punctured artery. Angiography of the radial artery was performed in 70 (68.0%) patients. Potential risk factors for radial artery spasm were evaluated.

Results:
The overall incidence of the radial artery spasm was high – 25 (24.3%). Signs of spasm were present in 37.1% of radial artery angiographies before the procedure and 60.1% after, however, it did not always indicate a symptomatic spasm. Risk factors related to radial artery spasm included female sex (OR = 2.94, p = 0.02), failure of the first puncture attempt (OR = 3.12, p = 0.014) and use of non-hydrophilic sheath (OR = 9.56, p = 0.036). Radial artery narrowing at the tip of the sheath was also a risk factor for spasm (p = 0.022). No spasms were observed after hydrophilic sheath application (n = 13). The administration of a radial cocktail was not observed to significantly decrease the spasm odds.

Conclusions:
Risk factors for radial artery spasm include female sex and multiple puncture attempts. Hydrophilic sheath coating protects against radial artery spasm. Overall signs of a spasm in the angiography are common and do not imply a symptomatic spasm, which can be predicted by a tight narrowing at the tip of the sheath.

keywords:

Radial artery spasms – angiographic morphology, risk factors and management

Jan Roczniak 1 , Andrzej Tarnawski 2 , Artur Dziewierz 1, 3 , Szymon Glanowski 4 , Artur Pawlik 1 , Karol Sabatowski 1 , Rafał Januszek 5 , Łukasz Rzeszutko 1, 3 , Andrzej Surdacki 1, 3 , Stanisław Bartuś 1, 3 , Michał Chyrchel 1, 3

cardiovascular interventions, radial access, radial artery angiography, radial artery spasm

Jan Roczniak

¹

,

Andrzej Tarnawski

²

,

Artur Dziewierz

^{1, 3}

,

Szymon Glanowski

⁴

,

Artur Pawlik

¹

,

Karol Sabatowski

¹

,

Rafał Januszek

⁵

,

Łukasz Rzeszutko

^{1, 3}

,

Andrzej Surdacki

^{1, 3}

,

Stanisław Bartuś

^{1, 3}

,

Michał Chyrchel

^{1, 3}