An Extremely Effective and Safe Approach of Guiding Catheter Crossing over Spasmodic Radial or (and) Brachial Artery in Patients Whose Percutaneous Coronary Intervention Was Undergone via Radial Artery Access

Objective: Percutaneous coronary intervention (PCI) via the radial artery access has more advantages than that of femoral artery access, while radial or (and) brachial artery have tendency to be spasmodic. We sought to investigate the effectiveness and safety of guiding catheter crossing over spasmodic radial or (and) brachial artery segments by the aid of PCI wire and balloon compared with traditional anti-spasmodic approach. Methods: The clinical data of 168 patients with coronary artery disease (CAD) (group A), whose PCI was performed via radial artery access with radial or (and) brachial artery spasm or (and) dissection and guiding catheter passing through spasmodic segments successfully by the aid of PCI guiding wire and balloon were analyzed retrospectively, simultaneously, the other 73 patients (group B) who used conventional approach to cross over the spasmodic radial or (and) brachial artery segments were treated as the control. The success rate, the time consumption and the complication were compared between the two groups. Findings: There was no significant difference in the spasmodic site between the two groups (all p value > 0.05). The success rate in group A was significantly higher than that in group B (168(100%) vs 28 (38.4%), p < 0.0001). As for those of successful crossover in the two groups, the time consumption of guiding catheter crossing over spasmodic segment in group A was shorter than that in group B (p < 0.0001). The incidence of forearm hematoma in group A was lower than that in group B (7(4.2%) vs 14 (19.2%), p < 0.0001). Conclusions: It is more effective and safer for guiding catheter crossing over spasmodic or (and) dissected radial or (and) brachial artery segments by the aid of PCI guiding wire and balloon than using the routine approach of administration of anti-spasm drugs for trans-radial PCI.