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Transitional changes of acetylcholine spasm provocation test procedures.
- Source :
-
Cardiovascular intervention and therapeutics [Cardiovasc Interv Ther] 2020 Oct; Vol. 35 (4), pp. 321-326. Date of Electronic Publication: 2019 Oct 22. - Publication Year :
- 2020
-
Abstract
- Intracoronary acetylcholine (ACh) testing has become popular in the world as a spasm provocation test as well as an ergonovine test. Intracoronary ACh test based on the Japanese Circulation Society guidelines is necessary to insert a temporary pace maker (PM). We analyzed the ACh spasm provocation test procedures retrospectively. We performed 1829 ACh spasm provocation testing during 28 years. We investigated the procedural approach sites of artery and vein. Femoral artery and vein approach, brachial artery and femoral vein approach, brachial artery and vein approach, radial artery and brachial vein approach, radial artery and femoral vein approach were performed in 292 patients (16.0%), 498 patients (27.2%), 589 patients (32.2%), 252 patients (13.8%), and 175 patients (9.6%), respectively. We could perform the ACh testing by the femoral artery and brachial artery in all patients, while the success rate of radial artery approach was 97.1%. We could also insert the temporary PM by the brachial vein in 94.8% (841/887) of the study patients, whereas we could insert the temporary PM in all femoral vein approach [100% (965/965)]. We experienced the pulmonary embolism by the femoral artery and vein approach in two patients, while we also had the arterio-venous fistula necessary for surgical repair in two patients by the brachial artery and vein approach. Although there was no difference about the procedure-related major complications among the various procedures, we had no pulmonary embolism or arterio-venous fistula by the radial artery and brachial vein approach. Considering the disinfection with povidone iodine, procedural performance or procedure-related complications by the ACh testing, we recommend that radial artery and brachial vein approach is more comfortable method of the future ACh testing not only for patients but also for operators.
- Subjects :
- Acetylcholine adverse effects
Acetylcholine pharmacology
Cardiac Pacing, Artificial methods
Coronary Angiography
Coronary Vasospasm chemically induced
Coronary Vessels drug effects
Diagnostic Techniques, Cardiovascular adverse effects
Ergonovine administration & dosage
Ergonovine adverse effects
Ergonovine pharmacology
Humans
Injections, Intra-Arterial
Retrospective Studies
Vasoconstrictor Agents adverse effects
Vasoconstrictor Agents pharmacology
Acetylcholine administration & dosage
Coronary Vasospasm diagnosis
Vasoconstrictor Agents administration & dosage
Subjects
Details
- Language :
- English
- ISSN :
- 1868-4297
- Volume :
- 35
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Cardiovascular intervention and therapeutics
- Publication Type :
- Academic Journal
- Accession number :
- 31641953
- Full Text :
- https://doi.org/10.1007/s12928-019-00624-7