Randomized Trial Comparing the Spasmolytic Effects of Nitroglycerin and Verapamil with Nitroglycerin Alone in Preventing Radial Artery Spasm during Cerebral Angiography

Abstract To evaluate the effectiveness of nitroglycerin alone compared with a combination of nitroglycerin and verapamil in preventing radial artery spasm during transradial diagnostic cerebral angiography. This double-blind randomized study involved 80 patients who were assigned to receive either 200 µg of nitroglycerin combined with 2.5 mg of verapamil or 200 µg of nitroglycerin alone. We compared hemodynamic changes, baseline and procedural parameters, as well as patient satisfaction between the two groups. The occurrence of radial artery occlusion was assessed using Doppler ultrasonography at 24 hours and 1 month following the procedure. Radial artery spasm occurred in three patients (7.5%) in the cocktail group and in four patients (10%) in the nitroglycerin-only group, with no statistically significant difference (p = 1.000). There were no significant differences in hemodynamic parameters, baseline characteristics, or procedural metrics. The majority of patients expressed satisfaction with the transradial approach. One case of radial artery occlusion was observed at the 1-month follow-up, with no differences noted between the groups. Nitroglycerin alone is equally effective as the combination of verapamil and nitroglycerin in preventing radial artery spasm.