Nicardipine to Avoid Spasm in Trans Radial Percutaneous Coronary Intervention
Status:
Recruiting
Trial end date:
2021-12-01
Target enrollment:
Participant gender:
Summary
Radial artery is the recommended route for percutaneous coronary intervention for it
significantly reduces net adverse clinical events compared to the femoral approach. The
success of the radial approach is therefore of a paramount importance. However, radial artery
spasm (RAS) remains one of the major limitations of transradial approach (TRA) and the most
frequent cause of TRA failure. Several recommendations has been issued to improve success
rate when using the radial route.
In the Tunisian difficult economic context, the use of low end equipment, the unavailability
of nitroglycerine and calcium antagonist verapamil, has led to the general feeling that RAS
and TRA failure has subsequently increased.
The standard and only used protocol by the Tunisian interventional cardiologist, consists of
administrating 1 mg isosorbide dinitrate through the arterial sheath immediately after radial
arterial puncture, therefore limiting the options to prevent RAS.
Nicardipine is the only injectable calcium antagonist available in Tunisia. Its spasmolytic
action on radial artery has been well demonstrated when used in CABG. However, it has been
very poorly investigated in trans radial percutaneous coronary intervention.
Investigators believe that the concomitant use of nicardipine with isorbide might
significantly reduce RAS and TRA failure when compared to isosorbide dinitrate only.