Radial artery size and Impact of Sub-cutaneous Vasodilators in Predominantly African American Population
Ahmad Awan, MD, Howard University Hospital, ARLINGTON, VA
Ahmad Awan, MD1, Mazhar Khalid2, Owens Igbinosa2, Julius Ngwa2 and Isaac Opoku, MD, FSCAI3, (1)Howard University Hospital, ARLINGTON, VA, (2)Howard University Hospital, Washington, DC, (3)Howard University Hospital, washington dc, DC
Keywords: Diversity Equity and Inclusion (DEI) and Vascular Access, Management, and Closure
Background:
Radial artery is preferred access for performance of coronary angiography and is increasing used in performance of peripheral interventions. However, effect of subcutaneous vasodilators is not well studied. In this retrospective, we compared radial artery size before and after subcutaneous injection of vasodilators in successive patients coming to cardiac catherization lab in single center.
Methods:
In this retrospective study, successive patients coming to cardiac catherization lab were enrolled. At Howard University Hospital, for local anesthesia, combination of 2mg of lidocaine and 2mg of nitroglycerin is given subcutaneously and radial artery size is measured pre and post local anesthesia. Radial artery size is measured from the image stored in ultrasound machine. Patients without images in ultrasound machine were excluded. Radial artery size is routinely measured 2-3 cm above the styloid process. Patient demographics and co-morbid conditions were calculated. Values are calculated as mean for continuous variable and count(%) for categorical variables. Generalized Linear regression model was used for Association of Radial artery size. Stepwise regression analysis was performed to account for difference in size. P value of less than 0.05 was considered significant
Results:
There were 513 patients in the study. Mean age of population was 62.67 years with 201 (46.96%) females. 92.87% patients were African American. Mean radial artery size prior to subcutaneous nitroglycerin was 0.241 cm
+0.045mm. Mean radial artery size post intervention is 0.262 cm
+0.045mm. There is statistically significant increase of 0.021cm size (p-value of 0.05). In univariate and multi-variate analaysis none of factors were significantly associated with differences in size.
Conclusions:
Subcutaneous injection of vasodilator mixed with lidocaine leads to significant increase in radial artery size. This finding is novel and will need to be further validated by randomized controlled trials.