In:
Cardiology, S. Karger AG, Vol. 140, No. 2 ( 2018), p. 74-82
Kurzfassung:
〈 b 〉 〈 i 〉 Objective: 〈 /i 〉 〈 /b 〉 We sought to demonstrate that the combination of a local vasodilator (verapamil), modern materials, patent hemostasis, and intravenous anticoagulant only in the case of percutaneous coronary intervention, as compared to default heparin administration after sheath insertion, may optimize a combined endpoint, including radial artery occlusion (RAO), radial artery spasm (RAS), and access site complication. 〈 b 〉 〈 i 〉 Methods: 〈 /i 〉 〈 /b 〉 This is a prospective, single-center, double-blind randomized trial. Overall, 418 patients undergoing a transradial approach (TRA) for coronary procedures were randomized 1: 1 to receive intraradial verapamil (5 mg) or heparin (5,000 IU) after a 6-Fr sheath insertion. The primary outcome was the 24-h occurrence of RAO (ultrasound confirmation), access site complication, and RAS requiring the bailout administration of vasodilators. 〈 b 〉 〈 i 〉 Results: 〈 /i 〉 〈 /b 〉 The combined primary outcome occurred in 127 (30%) patients. It was significantly lower in patients randomized to verapamil as compared to others (26 vs. 35%, 〈 i 〉 p 〈 /i 〉 = 0.03). This was mainly due to a significant reduction in RAS (3 vs. 10%, 〈 i 〉 p 〈 /i 〉 = 0.006). The 24-h and 30-day occurrence of RAO did not differ between the study groups. 〈 b 〉 〈 i 〉 Conclusion: 〈 /i 〉 〈 /b 〉 Local administration of verapamil versus heparin reduces RAS, without increasing RAO, which appears to be strictly related to radial artery diameter and hemostasis time.
Materialart:
Online-Ressource
ISSN:
0008-6312
,
1421-9751
Sprache:
Englisch
Verlag:
S. Karger AG
Publikationsdatum:
2018
ZDB Id:
1482041-9