Periprocedural Intermittent Contralateral Arm Ischemia Facilitates Radial Artery Puncture and Prevents Radial Artery Spasm

DOI: 10.5830/CVJA-2025-001

Abstract

Background: Transradial access (TRA) is a common technique used for diagnostic and interventional cardiac procedures. However, there are some challenges and complication risks. This study aimed to evaluate the impact of periprocedural intermittent ischemia of the contralateral arm on TRA and RAS.

MethodsWe enrolled 80 patients with an indication for coronary angiography between December 2017 and June 2018. Eighty patients were randomly grouped into two cohorts: intermittent contralateral arm ischemia (n=40) and control (n=40) groups.

Results: The radial artery puncture success ratio was higher in the intermittent contralateral arm ischemia group than in the control group (p=0.025). In multivariable logistic regression analysis, intermittent contralateral arm ischemia was significantly associated with radial artery puncture success (HR: 8.261, 95%CI: 1.427-47.823, p=0.018).

Discussion: Periprocedural intermittent contralateral arm ischemia increased the radial intervention success due to the remote ischemic preconditioning, vasodilator factors, and autonomic nervous system role.