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    
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.
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:  2014-09-05    
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    
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MeSH Terms
Brachial Artery / drug effects,  physiopathology*,  ultrasonography
Cardiac Catheterization / adverse effects*,  instrumentation
Coronary Angiography / adverse effects*,  instrumentation
Equipment Design
Laser-Doppler Flowmetry
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
Reg. No./Substance:
0/Vasodilator Agents; G59M7S0WS3/Nitroglycerin

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

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