{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T20:02:57Z","timestamp":1788292977215,"version":"build-2803163510"},"reference-count":54,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2022,11,6]],"date-time":"2022-11-06T00:00:00Z","timestamp":1667692800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Radial artery spasm (RAS) is the most common cause of transradial access site crossover and is a common intra\u2010procedural complication. RAS incidence can lead to radial artery occlusion (RAO) postprocedure, preventing the radial artery as a future access site. We evaluated the efficacy of nitroglycerin preventing RAS and RAO during transradial catheterization discussing the different routes of administration, including topical, subcutaneous, and intra\u2010arterial. A systematic review and meta\u2010analysis included all relevant articles until April 23, 2022. We searched six databases Google Scholar, Web of Science, SCOPUS, EMBASE, PubMed (MEDLINE), and CENTRAL. We registered our review protocol in PROSPERO with ID: CRD42022330356. We included 11 trials with 5814 patients. Compared to placebo, the pooled analysis favored subcutaneous nitroglycerin in preventing RAS (risk ratio [RR]: 0.57 with 95% confidence interval [CI] [0.43\u20130.77], <jats:italic>p<\/jats:italic>\u2009=\u2009.0003) and RAO (RR: 0.39 with 95% CI [0.16\u20130.98], <jats:italic>p<\/jats:italic>\u2009=\u2009.05). In contrast to the intra\u2010arterial nitroglycerin that showed nonstatistically significant results in preventing RAS and RAO (RR: 0.8 with 95% CI [0.63\u20131.02], <jats:italic>p<\/jats:italic>\u2009=\u2009.07)\u2010 (RR: 0.78 with 95% CI [0.6\u20131.01], <jats:italic>p<\/jats:italic>\u2009=\u2009.06)), respectively. Also, topical nitroglycerin did not prevent RAS (RR: 0.73 with 95% CI [0.42\u20131.24], <jats:italic>p<\/jats:italic>\u2009=\u2009.24). Compared with placebo, subcutaneous nitroglycerin during transradial catheterization reduced the incidence of RAS and RAO. Meanwhile, Intra\u2010arterial and topical nitroglycerin did not show statistically significant outcomes. Subcutaneous nitroglycerin may be a practical and cost\u2010effective technique to facilitate transradial catheterization; however, more RCTs are needed to evaluate the subcutaneous versus intra\u2010arterial nitroglycerin administration.<\/jats:p>","DOI":"10.1002\/clc.23906","type":"journal-article","created":{"date-parts":[[2022,11,6]],"date-time":"2022-11-06T19:58:17Z","timestamp":1667764697000},"page":"1171-1183","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":27,"title":["The efficacy of nitroglycerin to prevent radial artery spasm and occlusion during and after transradial catheterization: A systematic review and meta\u2010analysis of randomized controlled trials"],"prefix":"10.1002","volume":"45","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2919-6196","authenticated-orcid":false,"given":"Basel","family":"Abdelazeem","sequence":"first","affiliation":[{"name":"McLaren Health Care  Flint Michigan USA"},{"name":"Michigan State University  East Lansing Michigan USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed T.","family":"Abuelazm","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Tanta University  Tanta Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9983-2020","authenticated-orcid":false,"given":"Sarya","family":"Swed","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Aleppo University  Aleppo Syria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5302-5349","authenticated-orcid":false,"given":"Mohamed","family":"Gamal","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Tanta University  Tanta Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mostafa","family":"Atef","sequence":"additional","affiliation":[{"name":"Faculty of Medicine Cairo University  Cairo 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