Intensity of pain during coronary interventions via the radial artery

Abstract

Introduction: Radial access reduces vascular complications compared to femoral access. Various factors may influence the patient's pain during coronary intervention.

Aim: To assess what clinical and periprocedural factors affect discomfort and pain intensity during angiography via the radial artery without use of spasmolytics.

Material and methods: A group of 238 patients (M/F 142/96, mean age: 67 ±10 years) who underwent coronary angiography and interventions through the radial artery approach was studied. Every patient had ultrasound assessment of the radial artery. Pain was assessed according to the numerical pain rating scale, where mild pain is 1-3, moderate pain is 4-7, and severe pain is above 7.

Results: We included 238 patients. Most of the participants had a low pain level (n = 133 (55.88%)), while a smaller number had moderate and severe pain level (n = 88 (36.97%) and n = 17 (7.14%), respectively). We analyzed 38 characteristics of the patients in terms of the possible influence on the pain level during angiography.

Conclusions: In our study we analyzed possible factors which may contribute to the severe pain sensation during percutaneous coronary intervention. We found that masculine gender, greater weight and height as well as diabetes mellitus and myocardial infarction diagnosis on admission correlated with lower pain level. Conversely, greater maximal and minimal diameters of the radial artery correlated with stronger pain level.

Keywords: coronary angiography; coronary artery disease; pain during coronary angiography; pain scale.

Figure 1

PRISMA flowchart

Figure 2

A – Continous variables correlation with pain level. B – Categorical variables correlation with pain level