Abbreviations
CAG, Coronary angiography
RA, Radial artery
RAO, Radial artery occlusion
RAS, Radial artery spasm
TRA, Transradial
Dear Editor,
I read with interest the article titled "Comparison of Glidesheath Slender and Subcutaneous Nitrate Administration in Terms of Radial Artery Complications: A Retrospective Single-Center Experience1" published in your recent issue. However, I would like to make a few contributions to the article.
Radial artery spasm (RAS) is a significant issue during transradial (TRA) coronary angiography (CAG) and various methods are being explored to address this problem. Factors such as frequent catheter changes, prolonged procedure duration, increased sheath size, and operator inexperience have been shown to increase the risk of RAS.2 Despite preventive treatments such as subcutaneous nitrate and Glidesheath Slender sheath, this study shows high RAS rates compared to current data (13.8% and 20%).1 In our study involving patients undergoing elective TRA for CAG, the group receiving 300 mcg nitroglycerin via radial sheath showed a RAS rate of 4.8%, which was significantly lower than the other group. The overall RAS rate, including all patients, was 10.5%.3 The high RAS rate in this study emphasizes the importance of explaining methodology details such as whether patients underwent repeated punctures of the radial artery (RA), any differences in procedure duration between the two groups, whether there were variations in percutaneous intervention procedures, and the types and numbers of catheters used.
Two patients developed radial artery occlusion (RAO) in this study, but there is no data on follow-up RAO and RA stenosis. RA stenosis prevents the use of this artery in other procedures.4 Therefore, adding this data to the study would enhance its value.
DECLARATION OF CONFLICT OF INTEREST
Authors of this study do not have any conflict of interest.
Acknowledgments
None.
FUNDING/SUPPORTING INSTITUTIONS
None.
REFERENCES
- 1.Akbuga K, Celebi AS. Comparison of Glidesheath Slender and subcutaneous nitrate administration in terms of radial artery complications: a retrospective single-center experience. Acta Cardiol Sin. 2024;40:208–213. doi: 10.6515/ACS.202403_40(2).20231127A. [DOI] [PMC free article] [PubMed] [Google Scholar]
- 2.Lo TS, Nolan J, Fountzopoulos E, et al. Radial artery anomaly and its influence on transradial coronary procedural outcome. Heart. 2009;95:410–415. doi: 10.1136/hrt.2008.150474. [DOI] [PubMed] [Google Scholar]
- 3.Kanal Y, Kanal HEŞ. Radial arter yoluyla yapılan elektif koroner anjografi sırasında radial sheat içerisinden yapılan nitrogliserin dozu ile radial arter spazmının ilişkisi. Hitit Med J. 2023;5:216–220. [Google Scholar]
- 4.Kanal Y, Ozkan C. The relationship between amount of air supplied to radial artery compression device used after transradial procedure and radial artery stenosis. Acta Cardiol Sin. 2024;40:200–207. doi: 10.6515/ACS.202403_40(2).20231212A. [DOI] [PMC free article] [PubMed] [Google Scholar]