Comparison of Glidesheath Slender and Subcutaneous Nitrate Administration in Terms of Radial Artery Complications: A Retrospective Single-Center Experience

Abbreviations

RAS, Radial artery spasm

Dear Editor,

We read with great interest, the letter to our study published in the previous issue of your journal.

We understand that the authors observed that the rate of radial artery spasm (RAS) in our study is generally higher than that reported in the literature and in their own studies,¹ and they are curious about the reasons for this. In this regard, we defined RAS in our study² as the difficulty in catheter manipulation and advancement, regardless of the patient’s pain. However, in the authors’ study, the definition of RAS requires the patient to feel pain. This difference in definition might explain the higher rate of RAS in our study. Additionally, the ultrasound data in our study were limited to a specific group of patients, so the patient selection may not have been homogeneous.

We are sharing some data of patients who developed RAS in both patient groups in the tables below (Table 1 and Table 2).

Table 1. SC nitrate patient details.

	Patient 1	Patient 2	Patient 3	Patient 4	Patient 5	Patient 6	Patient 7	Patient 8	Patient 9	Patient 10	Patient 11	Patient 12	Patient 13
Height (cm)	175	161	180	184	195	158	160	182	155	170	175	171	175
Weight (kg)	74	88	120	123	92	76	79	81	80	70	90	95	100
Gender	Male	Male	Male	Male	Male	Female	Female	Male	Female	Male	Male	Male	Male
Age	59	62	53	47	39	53	51	56	65	64	53	42	67
RA diameter (mm)	24	28	26	25	22	22	17	22	23	24	20	20	22
DRA diameter (mm)	21	24	23	25	22	22	15	17	18	18	19	19	19
UA diameter (mm)	26	21	19	21	20	20	17	21	16	20	24	18	19
Former RA used	No	No	No	No	No	Yes	No	No	No	No	Yes	No	No
Sheat	6f	6f	6f	6f	6f	6f	5f	6f	6f	6f	6f	6f	6f
Sheat side	Radial	DRA	DRA	DRA	DRA	DRA	DRA	Radial	Radial	Radial	Radial	Radial	Radial
Right/left	Left	Left	Left	Left	Left	Left	Left	Left	Left	Left	Left	Left	Left
Puncture count	1	6	1	7	1	1	1	1	1	1	1	1	3
Cath used	1	2	9	2	2	2	2	4	2	5	3	3	2
7f cath	0	0	0	0	0	0	0	0	0	0	0	0	0
6f cath	1	0	6	0	0	0	0	0	0	2	1	0	0
5f cath	0	2	3	2	2	1	2	4	2	3	2	3	2
Heparin	5000	5000	5000	5000	5000	5000	5000	5000	5000	5000	5000	5000	7500
Heparin place	Sheath	Sheath	Sheath	Sheath	Sheath	Sheath	Sheath	Sheath	Sheath	Sheath	Sheath	Sheath	Sheath
Nitrate	200	200	300	400	500	200	300	300	300	900	200	200	600
SC nitrate	200	200	200	200	200	200	200	200	200	200	200	200	200
Procedure	ptca + stent	Medical	ptca + stent	Medical	Medical	Medical	Medical	Stent	Medical	cx ptca	Stent + ptca	Medical	Medical

Cath, catheter; DRA, distal radial artery; PCI, percutaneous coronary intervention; Ptca, percutaneous transluminal coronary angioplasty; RA, radial artery; SC, subcutaneous; UA, ulnar artery.

Table 2. GSS patient details.

	Patient 1	Patient 2	Patient 3	Patient 4	Patient 5	Patient 6	Patient 7
Height (cm)	172	182	165	155	170	170	160
Weight (kg)	68	75	73	80	100	91	87
Gender	Male	Male	Male	Female	Male	Male	Female
Age	40	51	53	75	49	77	71
RA diameter	22	26	31	23	23	20	25
DRA diameter	19	21	25	19	16	17	18
UA diameter	25	23	29	21	20	21	17
Former RA used	No	No	No	No	No	No	No
Sheath	5 slender	5f slender	6 slender	6f slender	6f slender	6f slender	6f slender
Sheath place	DRA	DRA	DRA	DRA	Radial	Radial	Radial
Right/left	Left	Left	Left	Left	Left	Left	Left
Puncture count	1	1	1	1	1	1	1
Caths used	4	3	3	2	2	2	2
7f cath	0	0	0	0	0	0	0
6f cath	0	0	1	0	0	2	0
5f cath	4	3	2	2	2	0	2
Guidewire(s)	1	1	1	1	1	1	1
Hidrophilic wire	1	1	0	0	0	0	0
Heparin	5000	5000	10000	5000	5000	10000	5000
Heparin place	Sheath	Sheath	Sheath	Sheath	Sheath	Sheath	Sheath
Nitrate	500	500	600	300	300	900	600
Procedure	Medical	Medical	PCI	Medical	Medical	PCI	Medical
Anatomical variation	0	0	0	0	High take off radial	0	0

Abbreviations are in Table 1.

Unfortunately, there is no follow-up data available regarding radial artery occlusion development in our patient group.

Sincerely

DECLARATION OF CONFLICT OF INTEREST

Authors of this study do not have any conflict of interest.

FUNDING/SUPPORTING INSTITUTIONS

None.