Acetylcholine spasm provocation test by trans-radial artery and brachial vein approach.
Acetylcholine
/ administration & dosage
Aged
Catheterization, Peripheral
/ adverse effects
Coronary Vasospasm
/ chemically induced
Coronary Vessels
/ diagnostic imaging
Feasibility Studies
Female
Heart Function Tests
/ adverse effects
Humans
Male
Middle Aged
Patient Safety
Predictive Value of Tests
Punctures
Radial Artery
Retrospective Studies
Risk Assessment
Risk Factors
Vasoconstriction
/ drug effects
Vasoconstrictor Agents
/ administration & dosage
Veins
acetylcholine
brachial vein
radial artery
spasm provocation test
Journal
Catheterization and cardiovascular interventions : official journal of the Society for Cardiac Angiography & Interventions
ISSN: 1522-726X
Titre abrégé: Catheter Cardiovasc Interv
Pays: United States
ID NLM: 100884139
Informations de publication
Date de publication:
01 07 2019
01 07 2019
Historique:
received:
15
12
2017
revised:
11
10
2018
accepted:
16
10
2018
pubmed:
15
12
2018
medline:
17
6
2020
entrez:
15
12
2018
Statut:
ppublish
Résumé
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. We examined the feasibility and safety of the acetylcholine spasm provocation test via the radial artery and brachial vein approach. 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. 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. We recommend the radial artery and brachial vein approach for safety and convenience when performing the acetylcholine spasm provocation tests.
Sections du résumé
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.
Substances chimiques
Vasoconstrictor Agents
0
Acetylcholine
N9YNS0M02X
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
38-44Informations de copyright
© 2018 Wiley Periodicals, Inc.