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CC BY 4.0 · Indian Journal of Neurosurgery
DOI: 10.1055/s-0046-1816062
Original Article

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

Authors

  • Vivek Premshankar Tiwari 

    1   Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh, India

  • Vikas Bhatia

    1   Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh, India

  • Ajay Kumar 

    1   Department of Radiodiagnosis and Imaging, PGIMER, Chandigarh, India

  • Ashish Aggarwal

    2   Department of Neurosurgery, PGIMER, Chandigarh, India

  • Rajesh Chabra

    2   Department of Neurosurgery, PGIMER, Chandigarh, India

  • Rajeev Chauhan

    3   Department of Anaesthesia, PGIMER, Chandigarh, India
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Abstract

Objective

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.

Methods

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.

Results

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.

Conclusion

Nitroglycerin alone is equally effective as the combination of verapamil and nitroglycerin in preventing radial artery spasm.

Keywords

cerebral angiography - DSA - radial access - vasospasm - radial cocktail - nitroglycerin


Publication History

Article published online:
28 January 2026

© 2026. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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