Document Detail

Impact of length and hydrophilic coating of the introducer sheath on radial artery spasm during transradial coronary intervention: a randomized study.
MedLine Citation:
PMID:  20488402     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: The aim of this study was to assess the impact of length and hydrophilic coating of the introducer sheath on radial artery spasm, radial artery occlusion, and local vascular complications in patients undergoing transradial coronary procedures.
BACKGROUND: Radial artery spasm is common during transradial procedures and the most common cause for procedural failure.
METHODS: We randomly assigned, in a factorial design, 790 patients scheduled for a transradial coronary procedure to long (23-cm) or short (13-cm) and hydrophilic-coated or uncoated introducer sheaths. The primary outcome measure was clinical evidence of radial artery spasm, and secondary outcome measures were patient discomfort and local vascular complications.
RESULTS: Procedural success was achieved in 96% of the cases, and radial artery spasm accounted for 17 of 33 failed cases. There was significantly less radial artery spasm (19.0% vs. 39.9%, odds ratio [OR]: 2.87; 95% confidence interval [CI]: 2.07 to 3.97, p < 0.001) and patient reported discomfort (15.1% vs. 28.5%, OR: 2.27; 95% CI: 1.59 to 3.23, p < 0.001) in patients receiving a hydrophilic-coated sheath. No difference was observed between long and short sheaths. Radial artery occlusion was observed in 9.5% of the patients and was not influenced by sheath length or coating. A local large hematoma or arterial dissection was seen in 2.6% of the patients with no difference in groups allocated at randomization. Younger age, female sex, diabetes, and lower body mass index were identified as independent predictors of radial artery spasm.
CONCLUSIONS: Hydrophilic sheath coating, but not sheath length, reduces the incidence of radial artery spasm during transradial coronary procedures.
Sudhir Rathore; Rodney H Stables; Maheshwar Pauriah; Abdul Hakeem; Joseph D Mills; Nick D Palmer; Raphael A Perry; John L Morris
Publication Detail:
Type:  Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  JACC. Cardiovascular interventions     Volume:  3     ISSN:  1876-7605     ISO Abbreviation:  JACC Cardiovasc Interv     Publication Date:  2010 May 
Date Detail:
Created Date:  2010-05-21     Completed Date:  2010-08-30     Revised Date:  2014-09-05    
Medline Journal Info:
Nlm Unique ID:  101467004     Medline TA:  JACC Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  475-83     Citation Subset:  IM    
Copyright Information:
Copyright 2010 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.
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MeSH Terms
Age Factors
Arterial Occlusive Diseases / etiology,  physiopathology,  prevention & control*
Body Mass Index
Cardiac Catheterization / adverse effects,  instrumentation*,  methods
Chi-Square Distribution
Coated Materials, Biocompatible*
Diabetes Complications / etiology,  prevention & control
Equipment Design
Foreign-Body Reaction / etiology
Hematoma / etiology
Logistic Models
Middle Aged
Odds Ratio
Prospective Studies
Radial Artery* / physiopathology
Risk Assessment
Risk Factors
Sex Factors
Single-Blind Method
Spasm / etiology,  physiopathology,  prevention & control*
Time Factors
Treatment Outcome
Vascular Patency
Reg. No./Substance:
0/Coated Materials, Biocompatible
Comment In:
JACC Cardiovasc Interv. 2010 Aug;3(8):885-6; author reply 886-7   [PMID:  20723865 ]
JACC Cardiovasc Interv. 2010 May;3(5):484-5   [PMID:  20488403 ]
JACC Cardiovasc Interv. 2010 Aug;3(8):885; author reply 886-7   [PMID:  20723866 ]

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