+ Resolve Article
+ Follow Us
Follow on FacebookFollow on Facebook
Follow on TwitterFollow on Twitter

+ Translate
+ Subscribe to Site Feed
GeoScience Most Shared ContentMost Shared Content

Catheter-induced coronary spasm--a view of mechanical factors and experience with selective left coronary arteriography

, : Catheter-induced coronary spasm--a view of mechanical factors and experience with selective left coronary arteriography. Zhonghua Yi Xue Za Zhi 63(2): 107-112

Coronary spasm during cardiac catheterization is not unusual. The mechanism of spasm remains uncertain, but is considered to be multifactorial. Many researchers believe that coronary spasm that develops during catheterization is partly spontaneous and partly catheter-induced. Because catheter-induced spasm results from mechanical irritation, we tried to find the iatrogenic factors that predispose patients to coronary spasm during coronary angiography. Retrospectively, we reviewed the records of 7,295 patients who underwent coronary angiography at our hospital from June, 1983 to November, 1997; coronary spasm was documented in 30 patients, who became the study group. We randomly selected 41 patients who had normal coronary arteries as the normal control group. After reviewing cine films of coronary angiography, we compared these two groups for several parameters. These parameters included the length and diameter of the left main coronary artery (LMC), the angle between the LMC and the aorta, the angle between the catheter tip and the LMC, whether the catheter tip came into contact with the vascular wall and whether there was vessel wall bulging, catheter size and catheter/LMC ratio. This angiographic data and the demographic features, including age, sex, history of hypertension, diabetes mellitus, smoking, previous myocardial infarction, family history of coronary artery disease, cholesterol and triglyceride levels and chest pain character (exertional or rest pain) were compared between the study patient group and the control group. The results disclosed that larger catheter size (7.1 +/- 0.6 mm vs 6.4 +/- 0.7 mm, p < 0.001), smaller LMC diameter (4.2 +/- 0.9 mm vs 4.9 +/- 1.0 mm, p = 0.004), larger catheter/LMC ratio (0.07 +/- 0.05 vs 0.05 +/- 0.03, p = 0.022), catheter contact with the vessel wall (27/30 vs 20/41, p < 0.001) and vessel bulging (18/30 vs 5/41, p < 0.001) were related to catheter-induced coronary spasm. We found that the catheter tip coming into contact with the vessel wall, vessel wall bulging and catheter/LMC ratio (odds ratio 8.92 x 10(14)) were statistically significant factors predisposing patients to catheter-induced coronary spasm. Multiple factors contribute to coronary spasm. Of those, mechanical or iatrogenic factors might predispose patients to spasm during coronary catheterization. These facts deserve our attention, because iatrogenically induced spasms may be avoided by meticulously selecting catheters and manipulating them gently.


PMID: 10677920

Other references

Lipton, M.J.; Brundage, B.H.; Higgins, C.B.; Boyd, D.P., 1986: Clinical applications of dynamic computed tomography. Progress in Cardiovascular Diseases 28(5): 349-366

Brunnacker Karl, 1967: General features of a loess and soil stratigraphy in the lower Rhine region. Pleistocene periglacial loess-paleosol sequences, correlation with terraces, Germany.

Anonymous, 1969: Costs of production of sugar in Lambayeque Province (Peru). All aspects of sugar production from planting to ultimate marketing of the finished, refined product, are costed in detailed tables, for the Lambayeque province of Peru. Main categories of costs considered are (a) agricultural; (b) industrial; (c)...

Cass, A.S.; Luxenberg, M.; Gleich, P.; Johnson, C.F., 1984: A 22-year followup of ileal conduits in children with a neurogenic bladder. Previously, the ileal conduit had been used in children for diversion of urine from the neurogenic bladder to prevent deterioration of the upper urinary tracts and to manage urinary incontinence. Long-term results after ileal conduits in children...

Koshkelova, E.N.; Frolov, I.P.; Orlov, V.A.; Bezukhova, Z.P.; Kerbabaeva, A.A.; Nasyrov, O.; Tolmacheva, N.V., 1987: Mycoflora of oases of Northern Turkmenistan. Regularities in the distribution of fungi in the oases are discussed, followed by a survey of fungi of different groups. Symptoms of fungus diseases of cultivated plants are described briefly. The systematic part gives morphological characters of...

Pinheiro, A., 1961: Postoperative pseudo-atelectatic opacities in 2 cases of aspergilloma of the lung. Jornal do Medico 44: 709-716

Platt B.S.; Stewart R.J.C., 1969: Effects of protein calorie deficiency on dogs part 2 morphological changes in the nervous system. Developmental Medicine & Child Neurology 11(2): 174-192

Gay, B.W.; Bufalini, J.J., 1972: Hydrogen peroxide in the urban atmosphere. Environmental Letters 3(1): 21-24

Jackson, A.L.; Rashed, H.; Cardoso, S.; Wong, F.; Werkman, R.; Thompson, J.; Abell, T.L., 2000: Assessment of gastric electrical activity and autonomic function among diabetic and nondiabetic patients with symptoms of gastroesophageal reflux. Gastroesophageal reflux disease (GERD) may present differently in patients with diabetes mellitus (DM) than in nondiabetics (NDM). We compared three tests in two patient groups with GERD symptoms: a DM group (n = 10) and a NDM group (n = 13). The...

Niederman, M.S., 2005: Challenges in the management of community-acquired pneumonia: the role of quinolones and moxifloxacin. Current strategies and guidelines for the treatment of community-acquired pneumonia are directed toward making care cost effective, by treating patients on an outpatient basis whenever possible. The use of the new fluoroquinolones could help to ac...