Catheter-induced Spasm in the Proximal Right Coronary Artery
Autor: | Hirokazu Habara, Tomoki Sakaue, Yasuhiro Sasaki, Hiroaki Kohno, Shozo Sueda, Kaori Fujimoto |
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Rok vydání: | 2019 |
Předmět: |
Male
Cardiac Catheterization right coronary artery medicine.medical_specialty Catheters chest pain coronary spastic angina medicine.medical_treatment Provocation test ischemic ECG change Coronary Vasospasm 030204 cardiovascular system & hematology Coronary Angiography Chest pain Angina Pectoris Angina 03 medical and health sciences 0302 clinical medicine Internal medicine medicine.artery otorhinolaryngologic diseases Internal Medicine Spastic medicine Humans cardiovascular diseases Aged Retrospective Studies Cardiac catheterization medicine.diagnostic_test business.industry General Medicine Middle Aged medicine.disease nervous system diseases body regions stomatognathic diseases Catheter Right coronary artery Angiography Cardiology Female Original Article 030211 gastroenterology & hepatology catheter-induced spasm medicine.symptom business |
Zdroj: | Internal Medicine |
ISSN: | 1349-7235 0918-2918 |
DOI: | 10.2169/internalmedicine.1483-18 |
Popis: | Objectives The clinical characteristics in patients with catheter-induced spasm in the proximal right coronary artery (RCA) are controversial. We performed a clinical analysis of catheter-induced spasm in the RCA. Methods We retrospectively analyzed 5,296 consecutive patients who underwent diagnostic or follow-up angiography during a 26-year period. During this period, we found 40 patients with catheter-induced spasm in the RCA. We compared the clinical characteristics and procedures of cardiac catheterization in patients with catheter-induced spasm in the RCA with those in patients without such spasm. Results The frequency of catheter-induced spasm in the RCA was 0.75% (40/5,296). We performed pharmacological spasm provocation tests in 36 of 40 patients after spasm relief. Positive spasm was observed in 32 patients (88.9%), and 25 patients (78.1%) had multiple spasms. The catheter procedures, including the approach sites (radial/brachial/femoral), catheter size (4/5/6Fr) and catheter type (Judkins right/Sones/Shared/Judkins left 3.5/Amplatz) were not markedly different between the two groups. A multivariate analysis showed that positive spasm [odds ratio (OR): 7.030, 95% confidence interval (CI): 1.920-25.700], a younger age (OR: 0.937, 95% CI: 0.910-0.965) and diabetes mellitus (OR: 0.278, 95% CI: 0.083-0.928) were the determinant factors for the catheter-induced spasm. Conclusion Approximately 80% of patients with catheter-induced spasm in the proximal RCA had coronary spastic angina. Positive provoked spasm was the most powerful determinant factor for catheter-induced spasm. |
Databáze: | OpenAIRE |
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