Impact of ischemic preconditioning on the radial artery vasomotor function

Abstract

To the Editor, Transcatheter radial access is the usual approach to perform a coronary angiography. The advantages of this access come with certain inherent limitations like radial spasm, endothelial dysfunction associated with the insertion of the introducer sheath, nonocclusive radial artery injuries, and postoperative artery occlusions.1 Ischemic preconditioning (IPC) is an experimental phenomenon with confirmed protective effects by applying ischemia-reperfusion cycles to different target organs even at a distance.2 We suggest that IPC may be relevant to prevent radial spasm, nonocclusive radial artery injuries, and arterial occlusion post-catheterization. This is a small pilot study of patients scheduled for diagnostic or therapeutic coronary angiography. After the radial artery catheterization we performed: An optical coherence tomography (OCT) of the radial artery after the administration of an anti-spasmolytic cocktail. An IPC protocol or sham procedure through randomization. An OCT of the radial artery after the protocol. An OCT after the procedure was completed. The PAI protocol consists of inflating the blood pressure cuff to 200 mmHg 3 times for 5 min with 5 min of rest between each ischemic cycle. The sham protocol is the same but here the cuff is inflated up to 10 mmHg only. The OCT (LightLab Imaging Inc, Abbott Vascular, United States) was performed by 2 independent...