Comparision of Various Vasodilators Regimen During Radial Corornary Angiogram: A Prospective Randomised Trial
Journal Title: Journal of Advances in Internal Medicine - Year 2016, Vol 5, Issue 1
Abstract
Background and Aims: Coronary intervention through radial artery is a preferred over femoral route. Different vasodilators are used to prevent radial artery spasm. Till date there is no study to compare the effects of various vasodilator regimes during radial coronary angiogram in Nepal. We aim to compare the efficacy of different vasodilator in our patients. Methods and Result: This is a single centre, prospective randomized trial between Verapamil, Nitroglycerine (GTN) and cocktail (Verapamil with GTN). All the patient undergoing coronary angiogram via radial approach, without the contraindication were randomized by a computer generated randomization protocol. Patient undergoing coronary procedures via the radial artery were divided into three groups. Patients in group A received intra-arterial cocktail (2.5 mg of Verapamil plus 100 mcg Nitroglycerine in 10 ml of normal saline), patients in group B received Verapamil (5mg) and patient in group C received Nitroglycerine (200mcg). Heparin of 3000U was given intravenously in all three groips. Altogether 207 patients underwent transradial coronary angiogram, 203 were randomized after exclusion. Over all Radial artery spasm was reported in 28 patients (13.79%). There was no statistically significant difference in spasm between the three regimens however when grading, there was significant higher grade of spasm in Verapamil group (13.23%, P value < 0.05). When comparing Verapamil and GTN separately there was significant higher spasm (21% vs 7%, P value < 0.05) with higher grades of spasm in verapamil group. Conclusion: Intra arterial vasodilators are frequently used as a spasmolytic during Trans- Radial angiogram. Our study showed that there is no difference in spasm when chosen between cocktail, verapamil and GTN. However while grading the spasm; there was greater propensity of high grade spasm among the verapamil users.
Authors and Affiliations
Rabi Malla| Department of Cardiology, Shahid Gangalal National Heart Centre, Bansbari, Kathmandu, Bishal KC*| Department of Cardiology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Chandramani Adhikari| Department of Cardiology, Shahid Gangalal National Heart Centre, Bansbari, Kathmandu, Binay K Rauniyar| Department of Cardiology, Shahid Gangalal National Heart Centre, Bansbari, Kathmandu, Deepak Limbu| Department of Cardiology, Shahid Gangalal National Heart Centre, Bansbari, Kathmandu, Bibek Baniya| Department of Cardiology, Shahid Gangalal National Heart Centre, Bansbari, Kathmandu, Sunil Dhungel| Department of Cardiology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Khagendra Jung Shah| Department of Cardiology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Sobita Khadka| Department of Cardiology, Shahid Gangalal National Heart Centre, Bansbari, Kathmandu, Sabita Aryal| Department of Cardiology, Shahid Gangalal National Heart Centre, Bansbari, Kathmandu, Pratikshya Joshi| Department of Cardiology, Shahid Gangalal National Heart Centre, Bansbari, Kathmandu, Aseem bhattrai| Department of biochemistry, Tribhuvan University Teaching Hospital, Kathmandu
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- EP ID EP4803
- DOI http://dx.doi.org/10.3126/jaim.v5i1.17065
- Views 413
- Downloads 20
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