Reduction in spasm with a long hydrophylic transradial sheath.

Caussin C, Gharbi M, Durier C, Ghostine S, Pesenti-Rossi D, Rahal S, Brenot P, Barri M, Durup F, Lancelin B., Hôpital Marie Lannelongue, Le Plessis Robinson.

OBJECTIVES: We aimed to assess the efficiency of a long hydrophilic sheath in reducing radial spasm for transradial approach.

BACKGROUND: Despite a lower access site complication rate, cardiac catheterization using transradial approach is not widely used. Radial spasm is one of the main issues for transradial angiography and percutaneous interventions. We assumed that radial artery protection using a long hydrophilic coated sheath would reduce radial spasm compared to a bare short sheath.

METHODS: Three hundred and fifty one patients (pts) admitted for transradial coronary angiography +/- percutaneous coronary intervention were randomly assigned to a long hydrophilic coated or a short sheath (control group). Primary end point was the occurrence of a radial spasm defined by significant patient pain evaluated by scale score (>4) or significant catheter frictions during manipulation. Procedure failure, radial occlusion and local complications were also assessed.

RESULTS: Radial spasm was significantly reduced when using the long coated compared to the short sheath in 7 (4%) Vs 32pts (18%) p<0.001. No difference was found regarding procedure failure respectively 1.2% Vs 0.6%, local complication 0.6% vs 1.2% and radial occlusion 3.5% vs 3.5%. CONCLUSION: Radial artery protection using the long hydrophilic coated sheath was efficient in the prevention of radial spasm for transradial approach.

Catheter Cardiovasc Interv. 2010 Mar 19. [Epub ahead of print]