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This study will be a randomized, single-blind, prospective trial designed to evaluate the efficacy and safety of intra-arterial (IA) Verapamil diluted with normal saline compared to undiluted IA Nicardipine during transradial access (TRA) for percutaneous coronary angiography. Patients who are 18 years or older and undergoing non-emergent percutaneous coronary angiography via TRA will be included. Patients who are non-English speaking, pregnant, or intubated will be excluded. Patients will be randomized to one of the two following groups:
The investigators will document the patient's level of discomfort on the Visual Analogue Scale 30 seconds before and after administration of IA Verapamil/Nicardipine. The investigators will also document the presence of radial artery spasms.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Verapamil | Active Comparator | Intra-arterial Verapamil 5 mg (2mL) diluted with 8 mL of normal saline |
|
| Nicardipine | Placebo Comparator | Intra-arterial Nicardipine 400 mcg undiluted (8mL) |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Verapamil | Drug | All patients routinely receive intra-arterial calcium channel blockers during transradial access for coronary angiography. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Radial Artery Spasm | The investigators will document the presence or absence of radial artery spasms with either 0,1, or 2. 0 will indicate no radial artery spasms. 1 will indicate radial artery spasms that did not require a change in strategy. 2 will indicate radial artery spasms that required a change in strategy such as alternate access. | approximately 30 minutes |
| Pain Prior to Intra-arterial Calcium Channel Blocker Administration | Pain prior to intra-arterial calcium channel blocker administration will be assessed through the Visual Analogue Pain scale (from 0 to 10). | 30 seconds prior to administration |
| Pain After Intra-arterial Calcium Channel Blocker Administration | Pain after intra-arterial calcium channel blocker administration will be assessed through the Visual analogue Pain Scale (from 0 to 10). | 30 seconds post administration |
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Inclusion Criteria
Exclusion Criteria
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| Name | Affiliation | Role |
|---|---|---|
| Khalil Ibrahim, MD | University of Illinois at Chicago | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| University of Illinois Hospital | Chicago | Illinois | 60612 | United States |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 39191616 | Derived | Patel K, Duckett M, Vidovich MI, Ibrahim K. Intra-arterial nicardipine versus verapamil during transradial access coronary catheterization. Cardiovasc Revasc Med. 2025 May;74:40-44. doi: 10.1016/j.carrev.2024.08.008. Epub 2024 Aug 20. |
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| ID | Term |
|---|---|
| D010292 | Paresthesia |
| D010146 | Pain |
| ID | Term |
|---|---|
| D020886 | Somatosensory Disorders |
| D012678 | Sensation Disorders |
| D009461 | Neurologic Manifestations |
| D009422 | Nervous System Diseases |
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| ID | Term |
|---|---|
| D014700 | Verapamil |
| D002121 | Calcium Channel Blockers |
| D009529 | Nicardipine |
| ID | Term |
|---|---|
| D010627 | Phenethylamines |
| D005021 | Ethylamines |
| D000588 | Amines |
| D009930 | Organic Chemicals |
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| Nicardipine | Drug | Calcium channel blocker |
|
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D049990 |
| Membrane Transport Modulators |
| D045504 | Molecular Mechanisms of Pharmacological Action |
| D020228 | Pharmacologic Actions |
| D020164 | Chemical Actions and Uses |
| D000077264 | Calcium-Regulating Hormones and Agents |
| D045505 | Physiological Effects of Drugs |
| D002317 | Cardiovascular Agents |
| D045506 | Therapeutic Uses |
| D004095 | Dihydropyridines |
| D011725 | Pyridines |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |