Effects of Verapamil on the Reduction of Radial Artery Thrombosis after Coronary Angiography: A Randomized Clinical Trial

Background: The trans-radial approach significantly reduces access bleeding and underlying vascular complications and is associated with lower health care costs than the transfemoral approach. One of the most common complications, however, is radial artery occlusion (RAO). Methods: This study investigates the effects of verapamil on radial artery thrombosis in patients referred to Taleghani Hospital in Tehran between 2020 and 2021. Patients were randomized into 2 groups: the first group received verapamil, nitroglycerin, and heparin and the second group nitroglycerin and heparin. To randomly assign 100 cases to the 2 experimental and control groups, we first formed a framework for sampling 100 people (from 1 to 100); then, based on the table of random numbers, we assigned the first 50 numbers to the experimental group and the remainder to the control group. The 2 groups were compared for radial artery thrombosis. Results: This study evaluated 100 candidates for coronary angiography in 2 groups of 50 with and without verapamil. The mean age was 58.6±11.2 years in the group with verapamil and 58.1±12.7 years in the group without verapamil (P=0.84). The difference between the 2 groups in terms of heart failure was statistically significant (P 0.028). The prevalence of clinical thrombosis was 2.0% in the group with verapamil and 22.0% in the group without verapamil (P 0.004). The prevalence of ultrasound-confirmed thrombosis was 4.0% in the group with verapamil and 36.0% in the group without verapamil (P 0.001). Conclusion: Intra-arterial injection of verapamil added to heparin and nitroglycerine during trans-radial angiography could significantly reduce RAO.