Phase 1, single-center, open-label clinical study to assess the safety and efficacy of topical nitroglycerin on dilation of the radial artery. Subjects will receive nitroglycerin ointment prior to scheduled PCI and radial artery measurements will be performed to determine mean increase in radial artery diameter at several time points. There will be 20 subjects enrolled in this study.
This is a phase I study evaluating the safety, tolerability, and efficacy of topical nitroglycerin prior to percutaneous coronary intervention (PCI). Although the ultimate plan is to evaluate this intervention vs placebo, it is important to first determine whether topical nitroglycerin not only is safe for patients, but whether it effectively dilates the radial artery. Given that patients who receive topical nitroglycerin applied to the chest for other reasons (angina or acute coronary syndrome, hypertension, etc) have reported headaches and/or have experienced decreased blood pressure, it is important to determine whether these noted side effects are present when nitroglycerin ointment is applied to the arm. Prior to initiating any study procedures, we will perform a Barbeau test to determine normal blood flow through the radial artery and collateral circulation from the ulnar artery through the palmar arch. After the ointment is applied, we will also be measuring the dimensions of the radial artery for the degree of dilation in order to determine whether topical nitroglycerin is indeed a possible method for increasing the rate of PCI performed using the transradial approach (TRA).
Study Type
INTERVENTIONAL
Allocation
NA
Purpose
OTHER
Masking
NONE
Enrollment
20
2 cm (30mg) of 2% nitroglycerin applied 2 cm from the styloid process of the anterior forearm
Change in systolic blood pressure
Changes in blood pressure measured by upper arm cuff pressure
Time frame: 45 minutes
Incidence of headache
Rate and severity of headache, determined by subject-reported symptoms.
Time frame: 45 minutes
Hematoma
Incidence of forearm hematoma development
Time frame: 45 minutes
Radial artery dilation
Change in radial artery dilation, measured by radial artery diameter using high-frequency (13MHz) linear array transducer 2cm proximal to the radial styloid process at 15 and 30 minute time points.
Time frame: 45 minutes
Punctures required
Number of radial artery punctures/attempts
Time frame: 45 minutes
Transradial conversions to transfemoral approach
Number of conversions to transfemoral approach
Time frame: 45 minutes
This platform is for informational purposes only and does not constitute medical advice. Always consult a qualified healthcare professional.