| Vascular dysfunction of brachial artery after transradial access for coronary catheterization: impact of smoking and catheter changes. | |
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MedLine Citation:
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PMID: 19926046 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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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:
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Type: Journal Article; Research Support, Non-U.S. Gov't |
Journal Detail:
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Title: JACC. Cardiovascular interventions Volume: 2 ISSN: 1876-7605 ISO Abbreviation: JACC Cardiovasc Interv Publication Date: 2009 Nov |
Date Detail:
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Created Date: 2009-11-20 Completed Date: 2010-01-27 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101467004 Medline TA: JACC Cardiovasc Interv Country: United States |
Other Details:
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Languages: eng Pagination: 1067-73 Citation Subset: IM |
Affiliation:
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Medizinische Klinik B, Heinrich-Heine University, D??sseldorf, Germany. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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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:
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0/Vasodilator Agents; 55-63-0/Nitroglycerin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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