Periprocedural intermittent contralateral arm ischaemia facilitates radial artery puncture and prevents radial artery spasm

Ahmet Korkmaz, Can Ozkan, Ozgul Ucar Elalmis, Umit Guray

Abstract

Background: Transradial access (TRA) is a common technique used for diagnostic and interventional cardiac procedures. However, there are some challenges and risks of complications. This study aimed to evaluate the impact of periprocedural intermittent ischaemia of the contralateral arm on TRA and radial artery spasm.
Methods: We enrolled 80 patients with an indication for coronary angiography between December 2017 and June 2018. The patients were randomly grouped into two cohorts: intermittent contralateral arm ischaemia (n = 40) and control (n = 40) groups.
Results: The radial artery puncture success ratio was higher in the intermittent contralateral arm ischaemia group than in the control group (p = 0.025). In multivariable logistic regression analysis, intermittent contralateral arm ischaemia was significantly associated with radial artery puncture success (hazard ratio: 8.261, 95% confidence interval: 1.427–47.823, p = 0.018).
Conclusion: Periprocedural intermittent contralateral arm ischaemia increased the radial intervention success due to the remote ischaemic preconditioning, vasodilator factors and autonomic nervous system role.