What are signs of radial artery spasm during catheterization?

• A. Resistant advancement of catheters, patient pain, and reduced or dampened arterial flow on Doppler.
• B. Bleeding at the access site.
• C. Increasing distal pulses.
• D. No symptoms.

Answer: (A)

Radial artery spasm is a sudden constriction of the radial artery smooth muscle during transradial catheterization. This tightening makes it hard to advance the catheter, which shows up as resistance to catheter progression. The patient often experiences pain in the forearm or hand due to the spasm, and the narrowed vessel diminishes blood flow, so Doppler assessment becomes reduced or dampened. Bleeding at the access site points to injury or hematoma rather than vasospasm. An increasing distal pulse would imply the artery is still well perfused and not in spasm, while no symptoms would suggest the absence of spasm. If spasm occurs, management includes vasodilators (like nitroglycerin), adequate analgesia, warmth, and sometimes changing the approach or sheath size to minimize further irritation.