For prevention or treatment of radial spasm, which is the best drug combination to be used?
There are several “cocktails” that operators give to prevent or treat arterial spasm. These include nitroglycerin, verapamil, diltiazem, nicardipine, papaverine, among others. Some of these agents can cause patient discomfort when administered arterially. Our preferred agent is nitroglycerin because it is readily available and does not cause any burning when given through the sheath. There have been some small randomized studies comparing agents and they all appear to be similar in terms of preventing spasm. I recommend watching many of the procedural videos on the Transradial University site as they provide insight into what agents are preferred by some of the high-volume radial operators.
