Cor Vasa 2021, 63(3):312-317 | DOI: 10.33678/cor.2020.099

Prevalence of post-procedural pain and associated factors experienced after transradial coronary angiography

Murat Gula, Burak Acarb, Ozlem Karabulutc, Mustafa Karanfilc, Sefa Unalc, Cagri Yaylac, Ahmet Goktug Ertemc, Ilke Erbayc, Derya Tokc, Burcu Demirkanc, Ayca Ozdemirc, Halil Lutfi Kisacikc
a Interventional Cardiology, Department of Cardiology, Aksaray University Education and Research Hospital, Aksaray, Turkey
b Interventional Cardiology, Department of Cardiology, Faculty of Medicine, Kocaeli, Kocaeli, Turkey
c Interventional Cardiology, Department of Cardiology, Yuksek Ihtisas Education and Research Hospital, Ankara, Turkey

Introduction: Coronary angiography is a principle diagnostic and therapeutic procedure in modern cardiology practice. The transradial access for cardiac catheterization has overtaken the transfemoral approach because of many advantages. However, some patients suffer radial pain after the procedure. Unfortunately, this complication has been poorly evaluated in previous studies. The present study aimed to determine the prevalence of radial pain after transradial coronary angiography and investigate factors that influence post-procedural pain.

Methods: This is a cross-sectional study in which a total of 100 consecutive patients who underwent elective transradial coronary angiography ± percutaneous coronary intervention between January 2015-2016 were evaluated. The patients were asked about presence of disturbing pain in the forearm especially wrist region after the procedure. Verbal rating scale was used to evaluate pain assessment. The patients were divided as early pain group (two hours after the procedure) and prolonged pain group (one month after the proce- dure) and analysis was performed.

Results: A total of 55 patients suffered from pain in the early phase (after two hours), and 26 of patients had prolonged pain at one month after the radial intervention. Independent pain predictors in the early pain group were male operator (p = 0.004, OR = 3.386, 95% CI: 1.484-7.725) and experience of operator (OR = 4.147, 95% CI: 1.637-10.506, p = 0.003). On the other hand, the younger age of patients (OR = 0.955, 95% CI: 0.915-0.966, p = 0.032) and experience of operator (OR = 3.947, 95% CI: 1.547-10.047, p = 0.004) were the independent predictors of prolonged radial pain.

Conclusion: Pain after radial coronary angiography is not uncommon. Experience, operator gender, and age of the patients were independent predictors of pain after transradial coronary angiography.

Keywords: Coronary angiography, Pain, Radial

Received: July 29, 2020; Revised: October 25, 2020; Accepted: October 29, 2020; Published: July 20, 2021  Show citation

ACS AIP APA ASA Harvard Chicago Chicago Notes IEEE ISO690 MLA NLM Turabian Vancouver
Gul M, Acar B, Karabulut O, Karanfil M, Unal S, Yayla C, et al.. Prevalence of post-procedural pain and associated factors experienced after transradial coronary angiography. Cor Vasa. 2021;63(3):312-317. doi: 10.33678/cor.2020.099.
Download citation

References

  1. Cooper CJ, El-Shiekh RA, Cohen DJ, et al. Effect of transradial access on quality of life and cost of cardiac catheterization: A randomized comparison. Am Heart J 1999;138(3 Pt 1):430-436. Go to original source... Go to PubMed...
  2. Mann T, Cubeddu G, Bowen J, et al. Stenting in acute coronary syndromes: a comparison of radial versus femoral access sites. J Am Coll Cardiol 1998;32:572-576. Go to original source... Go to PubMed...
  3. Garcia-Blas S, Mainar L, Sanchis J, Nunez J. Complex left main coronary stent restenosis treated through radial approach using a sheathless catheter. Rev Port Cardiol 2016;35:543e1-543e5. Go to original source...
  4. Dangoisse V, Guedes A, Gabriel L, et al. Full conversion from transfemoral to transradial approach for percutaneous coronary interventions results in a similar success rate and a rapid reduction of in-hospital cardiac and vascular major events. EuroIntervention 2013;9:345-352. Go to original source... Go to PubMed...
  5. Jolly SS, Yusuf S, Cairns J, et al. Radial versus femoral access for coronary angiography and intervention in patients with acute coronary syndromes (RIVAL): a randomised, parallel group, multicentre trial. Lancet 2011;377:1409-1420. Go to original source... Go to PubMed...
  6. Giannopoulos G, Raisakis K, Synetos A, et al. A predictive score of radial artery spasm in patients undergoing transradial percutaneous coronary intervention. Int J Cardiol 2015;188:76-80. Go to original source... Go to PubMed...
  7. Desbiens NA, Wu AW, Broste SK, et al. Pain and satisfaction with pain control in seriously ill hospitalized adults: findings from the SUPPORT research investigations. For the SUPPORT investigators. Study to Understand Prognoses and Preferences for Outcomes and Risks of Treatment. Crit Care Med 1996;24:1953-1961. Go to original source... Go to PubMed...
  8. Dai Y, Li C, Zhang F, et al. Safety and Efficacy of Percutaneous Coronary Intervention via Transradial Versus Transfemoral Approach in Bypass Grafts. Angiology 2018;69:136-142. Go to original source... Go to PubMed...
  9. Kim JY, Yoon J, Yoo BS, et al. The effect of a eutectic mixture of local anesthetic cream on wrist pain during transradial coronary procedures. J Invasive Cardiol 2007;19:6-9. Go to PubMed...
  10. Ruiz-Salmeron RJ, Mora R, Masotti M, Betriu A. Assessment of the efficacy of phentolamine to prevent radial artery spasm during cardiac catheterization procedures: a randomized study comparing phentolamine vs. verapamil. Catheter Cardiovasc Interv 2005;66:192-198. Go to original source... Go to PubMed...
  11. Ruiz-Salmeron RJ, Mora R, et al. Radial artery spasm in transradial cardiac catheterization. Assessment of factors related to its occurrence and of its consequences during follow-up. Rev Esp Cardiol 2005;58;504-511. Go to original source...
  12. Hensey M, Cronin E, Owens P. Influence of radial anatomy on pain experienced during transradial coronary angiography. Int J Cardiol 2016;218:202-205. Go to original source... Go to PubMed...
  13. Hawker GA, Mian S, Kendzerska T, French M. Measures of adult pain: Visual Analog Scale for Pain (VAS Pain), Numeric Rating Scale for Pain (NRS Pain), McGill Pain Questionnaire (MPQ), Short-Form McGill Pain Questionnaire (SF-MPQ), Chronic Pain Grade Scale (CPGS), Short Form-36 Bodily Pain Scale (SF-36 BPS), and Measure of Intermittent and Constant Osteoarthritis Pain (ICOAP). Arthritis Care Res 2011;63(Suppl. 11):S240-S252. Go to original source... Go to PubMed...
  14. Deveci B, Ozeke O, Gul M, et al. Impact of the radial versus femoral access for primary percutaneous intervention on smoking cessation rates: A paradoxus between the health related quality of life and smoking quitting? Cor Vasa 2018;60:e381-e386. Go to original source...
  15. Amoroso G, Kiemeneij F. Transradial access for primary percutaneous coronary intervention: the next standard of care? Heart 2010;96:1341-1344. Go to original source... Go to PubMed...
  16. Siudak Z, Zawislak B, Dziewierz A,et al. Transradial approach in patients with ST- elevation myocardial infarction treated with abciximab results in fewer bleeding complications: data from EUROTRANSFER registry. Coron Artery Dis 2010;21:292-297. Go to original source... Go to PubMed...
  17. Hahalis G, Tsigkas G, Kakkos S,et al. Vascular Complications Following Transradial and Transulnar Coronary Angiography in 1600 Consecutive Patients. Angiology 2016;67:438-443. Go to original source... Go to PubMed...
  18. Kubiak G, Traczewska, M. Percutaneous coronary interventions via the radial approach - Mandatory or elective in the current circumstances - A Polish perspective.Cor Vasa 2013;55:e515-e519. Go to original source...
  19. Coghill EM, JohnsonT, Morris RE, et al. Radial artery access site complications during cardiac procedures, clinical implications and potential solutions: The role of nitric oxide. World J Cardiol 2020;12:26-34. Go to original source... Go to PubMed...
  20. Coppola J, Patel T, Kwan T,et al. Nitroglycerin, nitroprusside, or both, in preventing radial artery spasm during transradial artery catheterization. J Invasive Cardiol 2006;18:155-158. Go to PubMed...
  21. Varenne O, Jegou A, Cohen R, et al. Prevention of arterial spasm during percutaneous coronary interventions through radial artery: the SPASM study. Catheter Cardiovasc Interv 2006;68:231-235. Go to original source... Go to PubMed...
  22. Bi X, Wang Q, Liu D, et al. Is the Complication Rate of Ulnar and Radial Approaches for Coronary Artery Intervention the Same? Angiology 2017;68:919-925. Go to original source... Go to PubMed...
  23. Casale M, Quattrocchi S, Bitto R, Dattilo G. Cardiac implantable devices and takotsubo syndrome. A rare but potential eventuality. Cor Vasa 2018;60:e500-e502. Go to original source...
  24. Wallis CJ, Ravi B, Coburn N, et al. Satkunasivam R. Comparison of postoperative outcomes among patients treated by male and female surgeons: a population based matched cohort study. BMJ 2017;359:j4366. Go to original source... Go to PubMed...
  25. Lou Z, Yan FH, Zhao ZQ, et al. The Sex Difference in Basic Surgical Skills Learning: A Comparative Study. J Surg Educ 2016;73:902-905. Go to original source... Go to PubMed...
  26. Lautenbacher S, Peters JH, Heesen M, et al. Age changes in pain perception: A systematic-review and meta-analysis of age effects on pain and tolerance thresholds. Neurosci Biobehav Rev 2017;75:104-113. Go to original source... Go to PubMed...

This is an open access article distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 International License (CC BY-NC 4.0), which permits non-comercial use, distribution, and reproduction in any medium, provided the original publication is properly cited. No use, distribution or reproduction is permitted which does not comply with these terms.





Cor et Vasa

You are accessing a site intended for medical professionals, not the lay public. The site may also contain information that is intended only for persons authorized to prescribe and dispense medicinal products for human use.

I therefore confirm that I am a healthcare professional under Act 40/1995 Coll. as amended by later regulations and that I have read the definition of a healthcare professional.