Acetylcholine spasm provocation test by trans-radial artery and brachial vein approach

Autor: Hiroaki Kohno, Hirokazu Habara, Kaori Fujimoto, Shozo Sueda, Yasuhiro Sasaki, Tomoki Sakaue
Rok vydání: 2018
Předmět:
Male
Bradycardia
medicine.medical_specialty
Provocation test
Femoral vein
Coronary Vasospasm
Punctures
030204 cardiovascular system & hematology
Chest pain
Risk Assessment
Veins
03 medical and health sciences
0302 clinical medicine
Left coronary artery
Predictive Value of Tests
Risk Factors
medicine.artery
Internal medicine
Catheterization
Peripheral
medicine
Humans
Vasoconstrictor Agents
Radiology
Nuclear Medicine and imaging
cardiovascular diseases
030212 general & internal medicine
Radial artery
Internal jugular vein
Aged
Retrospective Studies
business.industry
General Medicine
Middle Aged
Coronary Vessels
Acetylcholine
Vasoconstriction
Right coronary artery
Heart Function Tests
Radial Artery
cardiovascular system
Cardiology
Feasibility Studies
Female
Patient Safety
medicine.symptom
Cardiology and Cardiovascular Medicine
business
Zdroj: Catheterization and Cardiovascular Interventions.
ISSN: 1522-1946
Popis: BACKGROUND Temporary pace maker is necessary because of transient block or bradycardia during the intracoronary acetylcholine spasm provocation tests based on the Japanese Circulation Society guidelines. OBJECTIVES We examined the feasibility and safety of the acetylcholine spasm provocation test via the radial artery and brachial vein approach. METHODS We tried to perform the acetylcholine spasm provocation tests in 252 patients via the radial artery and brachial vein approach procedures during 5 years. Acetylcholine was injected in incremental doses of 20/50/80 μg into the right coronary artery (RCA) and 20/50/100/200 μg into the left coronary artery (LCA). Back-up pacing rate was set at 40 beats/min. Positive spasm was defined as transient ≥90% luminal narrowing and ischemic electrocardiographic change or usual chest pain. RESULTS The procedure success of radial artery and brachial vein access was 94.4% (238/252) and 93.3% (235/252), respectively. We performed 221 patients (87.7%) with acetylcholine tests by radial artery and brachial vein approach. We changed to the brachial approach due to the failures of radial artery access in 14 patients. We also changed to the femoral vein in 11 patients and internal jugular vein in two patients. Back-up pace maker rhythm was observed in 92.1% (232/252) of all study patients, while it was significantly higher in the RCA testing than that in the LCA tests (84.9% (191/225) vs. 52.2% (131/251), P < 0.001). No irreversible complication was found. CONCLUSIONS We recommend the radial artery and brachial vein approach for safety and convenience when performing the acetylcholine spasm provocation tests.
Databáze: OpenAIRE
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