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Radial artery access site complications during cardiac procedures, clinical implications and potential solutions : the role of nitric oxide

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Coghill_2020_WJC_Radialartery_CC.pdf (792.0Kb)
Date
26/01/2020
Author
Coghill, Emma M
Johnson, Timothy
Morris, Russell E
Megson, Ian L
Leslie, Stephen J
Keywords
Radial artery
Cannulation
Spasm
Nitric oxide
Vasodilation
Nanoporous material
RZ Other systems of medicine
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Abstract
Percutaneous coronary intervention for the treatment of coronary artery disease is most commonly performed in the UK through the radial artery, as this is safer than the femoral approach. However, despite improvements in technology and techniques, complications can occur. The most common complication, arterial spasm, can cause intense pain and, in some cases, procedural failure. The incidence of spasm is dependent on several variables, including operator experience, artery size, and equipment used. An anti-spasmolytic cocktail can be applied to reduce spasm, which usually includes an exogenous nitric oxide (NO) donor (glyceryl trinitrate). NO is an endogenous local vasodilator and therefore is a potential target for anti-spasm intervention. However, systemic administration can result in unwanted side-effects, such as hypotension. A method that adopts local delivery of NO might be advantageous. This review article describes the mechanisms involved in radial artery spasm, discusses the advantages and disadvantages of current strategies to reduce spasm, and highlight the potential of NO-loaded nanoporous materials for use in this setting.
Citation
Coghill , E M , Johnson , T , Morris , R E , Megson , I L & Leslie , S J 2020 , ' Radial artery access site complications during cardiac procedures, clinical implications and potential solutions : the role of nitric oxide ' , World Journal of Cardiology , vol. 12 , no. 1 , pp. 26-34 . https://doi.org/10.4330/wjc.v12.i1.26
Publication
World Journal of Cardiology
Status
Peer reviewed
DOI
https://doi.org/10.4330/wjc.v12.i1.26
ISSN
1949-8462
Type
Journal item
Rights
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved. This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Description
Supported by the European Social Fund and Scottish Funding Council as part of Developing Scotland’s Workforce in the Scotland 2014-2020 European Structural and Investment Fund Programme.
Collections
  • University of St Andrews Research
URI
http://hdl.handle.net/10023/19386

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