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Nitroglycerin Patch Facilitates Transradial Approach

06/24/2021

Introduction

Video supplement to "Transdermal Nitroglycerin Patch as a Potential Pretreatment to Prevent Radial Artery Spasm During Transradial Cardiac Catheterization," by Murai, et al. (July 2021 Clinical Images).

A 71-year-old female was hospitalized due to suspected coronary artery stenosis on multislice computed tomography. Elective coronary angiography was performed in which the guidewire for sheath insertion could not be advanced into radial artery due to its tortuosity and multiple stenoses. The following video demonstrates careful manipulation of the guidewire and eventual passage. Due to significant stenosis in her left anterior descending artery, PCI was performed 1 month later. Her left radial was selected again for the PCI due to occlusion of her brachiocephalic artery. Due to concern for radial artery vasospasm, a nitroglycerin transdermal patch was successfully utilized to facilitate advancement of the guidewire and insertion of a 6 Fr sheath without any patient discomfort.

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