Document Detail


Vascular dysfunction of brachial artery after transradial access for coronary catheterization: impact of smoking and catheter changes.
MedLine Citation:
PMID:  19926046     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: The aim of this study was to investigate the effect of diagnostic transradial catheterization on vascular function of upstream brachial artery (BA).
BACKGROUND: The transradial access has recently become an alternative to transfemoral cardiac catheterization. A potential caveat of this approach lies in possible sustained physical radial artery (RA) damage.
METHODS: We studied 30 patients (age 61 +/- 11 years) undergoing diagnostic coronary angiography with the transradial access (5-F). Endothelium-dependent, flow-mediated vasodilation (FMD) was measured before and at 6 and 24 h after catheterization of the right-sided RA and BA with high-resolution ultrasound. The left-sided RA served as a control.
RESULTS: Transradial catheterization significantly decreased FMD in the RA (overall mean 8.5 +/- 1.7% to 4.3 +/- 1.6%) and the upstream BA (overall mean 4.4 +/- 1.6% to 2.9 +/- 1.6%) at 6 h. Subgroup analysis showed that FMD of both arteries at 6 h was significantly lower in active smokers and that it only remained impaired at 24 h in this group, whereas nonsmoker FMD fully recovered. The degree of BA but not RA FMD dysfunction was related to the number of catheters used, with no change after 2 catheters, 1.9 +/- 1.2% decrease (6 h) and recovery (24 h) after 3 catheters, and 3.9 +/- 1.2% decrease (6 h) without recovery (24 h) after 4 to 5 catheters. The RA dysfunction correlated with the baseline diameter. The contralateral control RA exhibited no change ruling out systemic effects.
CONCLUSIONS: Transradial catheterization not only leads to dysfunction of the RA but also the upstream BA, which is more severe and sustained in smokers and with increasing numbers of catheters.
Authors:
Christian Heiss; Jan Balzer; Till Hauffe; Sandra Hamada; Emilia Stegemann; Thomas Koeppel; Marc W Merx; Tienush Rassaf; Malte Kelm; Thomas Lauer
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  JACC. Cardiovascular interventions     Volume:  2     ISSN:  1876-7605     ISO Abbreviation:  JACC Cardiovasc Interv     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-11-20     Completed Date:  2010-01-27     Revised Date:  2012-08-29    
Medline Journal Info:
Nlm Unique ID:  101467004     Medline TA:  JACC Cardiovasc Interv     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1067-73     Citation Subset:  IM    
Affiliation:
Medizinische Klinik B, Heinrich-Heine University, Düsseldorf, Germany.
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MeSH Terms
Descriptor/Qualifier:
Aged
Brachial Artery / drug effects,  physiopathology*,  ultrasonography
Coronary Angiography / adverse effects*,  instrumentation
Equipment Design
Female
Heart Catheterization / adverse effects*,  instrumentation
Humans
Laser-Doppler Flowmetry
Male
Middle Aged
Nitroglycerin / administration & dosage
Radial Artery / drug effects,  physiopathology*,  ultrasonography
Recovery of Function
Risk Assessment
Risk Factors
Smoking / adverse effects*
Time Factors
Vascular Diseases / etiology*,  physiopathology,  ultrasonography
Vasodilation* / drug effects
Vasodilator Agents / administration & dosage
Chemical
Reg. No./Substance:
0/Vasodilator Agents; 55-63-0/Nitroglycerin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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