Effect of transdermally applied nitroglycerin or lidocaine before transradial coronary angiography on procedure success and complications

Objective: We investigated the effect of transdermal nitroglycerin or lidocaine application on puncture time, number, and complications in patients who underwent transradial coronary angiography. Methods: Patients with topical saline applied to the radial artery before the procedure were designated as Group 1 (n=59), those with topical nitrate were designated as Group 2 (n=43), and those with topical lidocaine were designated as Group 3 (n=40). The groups' puncture time, number, and complication rates were compared. Results: While our average puncture time was 142±122 seconds in all patients, this time was measured as 171±131 seconds in Group 1, 88±48 seconds in Group 2, and 157±146 seconds in Group 3 (P=0.021). During the procedure, radial artery spasm was observed in 15.2% of patients in Group 1, 6.9% in Group 2, and 12.5% in Group 3 (P=0.043). Radial artery occlusion was seen in 8% of patients in Group 1, and 2.5% in Group 3, while it was not observed at all in the nitrate-applied group (P=0.041). Conclusion: The topical application of nitroglycerin before transradial angiography is a feasible strategy to reduce radial puncture time and number, facilitate trans-radial catheterization, and decrease the incidence of radial artery spasm and occlusion.