Department of Cardiology, First Affiliated Hospital of Shantou University Medical College, China (Y.C., Z.K., J.X., M.L., X.H., C.Y., X.T.).
Cardiovascular Genetics Laboratory, Shantou University Medical College, China (S.Y.).
Circ Cardiovasc Interv. 2018 Jul;11(7):e006571. doi: 10.1161/CIRCINTERVENTIONS.118.006571.
Transradial coronary catheterization is widely used as a diagnostic or interventional procedure for coronary disease. However, it can lead to adverse complications, such as radial artery occlusion. We sought to determine whether preprocedural injection of nitroglycerin at the radial artery puncture site reduces radial artery occlusion.
A total of 188 patients undergoing transradial coronary catheterization were randomized in a single-blind fashion to receive subcutaneous injection of 0.5 mL 0.1% nitroglycerin or a placebo at the radial artery puncture site. The participants underwent ultrasound examinations of the radial artery before and at 24 hours after the procedure. Of the 188 patients enrolled, 182 completed the study, as the procedure failed in 2 participants in the nitroglycerin-treated group and 4 in the placebo group. Baseline demographic and clinical characteristics were similar between 2 groups. Comparing the radial artery diameters before and after the operation, there was a statistically significant increase in the nitroglycerin-treated group (2.48±0.45 versus 2.45±0.46 mm; =0.003) but a decrease in the placebo control group (2.41±0.50 versus 2.46±0.49 mm; <0.001). Importantly, the incidence of radial arterial occlusion was substantially lower in the nitroglycerin-treated group than in the placebo control group (5.4% versus 14.4%; =0.04). There was not significant difference in other complications (forearm hematoma and radial artery pseudoaneurysm, respectively), and there was no incidence of cause hypotension or an intolerable headache.
Subcutaneous injection of nitroglycerin at the radial artery puncture site dilates the radial artery and reduces the incidence of early radial artery occlusion post-catheterization.
URL: https://www.chictr.org.cn. Unique identifier: ChiCTR-IPR-15006559.
经桡动脉冠状动脉造影术已广泛应用于冠心病的诊断和介入治疗。然而，它可能导致不良并发症，如桡动脉闭塞。我们旨在确定经桡动脉穿刺部位预先注射硝酸甘油是否能降低桡动脉闭塞的发生率。
188 例接受经桡动脉冠状动脉造影术的患者被随机分为两组，采用单盲法，在桡动脉穿刺部位皮下注射 0.5ml0.1%硝酸甘油或安慰剂。所有患者均在术前和术后 24 小时行桡动脉超声检查。188 例患者中，182 例完成了研究，因为在硝酸甘油组有 2 例和安慰剂组有 4 例手术失败。两组患者的基线人口统计学和临床特征相似。比较手术前后桡动脉直径，硝酸甘油组桡动脉直径明显增加（2.48±0.45 比 2.45±0.46mm；=0.003），而安慰剂对照组桡动脉直径减少（2.41±0.50 比 2.46±0.49mm；<0.001）。重要的是，硝酸甘油组桡动脉闭塞的发生率明显低于安慰剂对照组（5.4%比 14.4%；=0.04）。两组患者的其他并发症（前臂血肿和桡动脉假性动脉瘤）发生率无显著差异，也无低血压或无法耐受的头痛发生。
经桡动脉穿刺部位皮下注射硝酸甘油可扩张桡动脉，降低经导管治疗后早期桡动脉闭塞的发生率。
