Catheter-induced Spasm in the Proximal Right Coronary Artery

Autor: Hirokazu Habara, Tomoki Sakaue, Yasuhiro Sasaki, Hiroaki Kohno, Shozo Sueda, Kaori Fujimoto
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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