Radial artery access site complications during cardiac procedures, clinical implications and potential solutions: The role of nitric oxide

Table 1 Complications from radial artery puncture

Complication	Frequency (%)
Radial artery spasm[11,18,19,24,26,34-36]	1-34
Radial artery occlusion[11,19,24,26,35-37]	Up to 19.7
Haematoma[11,19,24,35]	Up to 14.4
Dissection[35,36]	Very rare (0.4)
Compartment Syndrome[26,36]	Very rare
Pseudoaneurysm formation[11,19,26,35,36]	Very rare up to 2.78
Infection[19,35]	Up to 3.4
Perforation[26,36]	Very rare

Table 2 Variations of anti-spasmolytic cocktail components

Ref.	Radial cocktailingredients	Concentration	Drug class
Kiemeneij et al[32]	Verapamil	5 mg	Calcium channel blocker1
	Nitroglycerin	0.2 mg	Nitrate2
Pancholy et al[44]	Nitroglycerin	0.2 mg	Nitrate2
	Diltiazem	5 mg	Calcium channel blocker1
Hizoh et al[43]	Verapamil	5 mg	Calcium channel blocker1
He et al[23]	Heparin	2500 units	Anticoagulant3
	Nitroglycerin	0.2 mg	Nitrate2
	Verapamil	2.5 mg	Calcium channel blocker1
Ruiz-Salmerón et al[24]	Heparin with	5000 units	Anticoagulant3
	Verapamil or	2.5 mg	Calcium channel blocker1
	Phentolamine	2.5 mg	Alpha-adrenergic antagonist1

¹Disrupts the movement of calcium through calcium channels, causing vasodilation.

²Activates guanyl cyclase and increases cyclic guanosine monophosphate causing vasodilation;

³Inhibits coagulation, preventing thrombus formation.