{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T20:37:36Z","timestamp":1790973456862,"version":"4.1.0"},"reference-count":26,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"2","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2014,3,24]]},"abstract":"<jats:sec xml:lang=\"en\">\n            <jats:title>Background<\/jats:title>\n            <jats:p xml:lang=\"en\">Verapamil is traditionally applied prophylactically in transradial procedures to prevent radial artery spasm. However, verapamil may have side effects and is contraindicated in some clinical settings.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Methods and Results<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              During an investigator\u2010initiated, randomized, double\u2010blind trial, we evaluated the need for preventive verapamil administration. After vascular access was established, patients received either 5\u00a0mg verapamil (n=297) or placebo (n=294). We compared the rate of access site conversions as primary end point using a superiority margin of 5%. Occurrence of code breaks (composite of conversions and unplanned use of verapamil), overall verapamil use, procedural and fluoroscopic times, contrast volume, and subjective pain were investigated as secondary end points. The rate of access site conversions was not different in the 2 arms (placebo 1.7% versus verapamil 0.7%,\n              <jats:italic>P<\/jats:italic>\n              =0.28, difference 1.0%, 95% CI for the difference \u22121.1% to 3.3%). Proportion of code breaks was similar in the 2 groups (3.4% versus 1.3%,\n              <jats:italic>P<\/jats:italic>\n              =0.11), whereas overall verapamil use was markedly lower in the placebo arm (2.0% versus 100%,\n              <jats:italic>P<\/jats:italic>\n              &lt;0.0001). Procedural time (median [\n              <jats:styled-content style=\"fixed-case\">IQR<\/jats:styled-content>\n              ] 16.0 minutes [9.0 to 30.0 minutes] versus 17.0 minutes [10.0 to 31.0 minutes],\n              <jats:italic>P<\/jats:italic>\n              =0.37), fluoroscopic time (4.4 minutes [2.1 to 9.6 minutes] versus 4.8 minutes [2.4 to 10.7 minutes],\n              <jats:italic>P<\/jats:italic>\n              =0.28), contrast volume (72.5\u00a0mL [48.0 to 146.0 mL] versus 75.5\u00a0mL [47.0 to 156.5 mL],\n              <jats:italic>P<\/jats:italic>\n              =0.74), and pain score (\n              <jats:italic>P<\/jats:italic>\n              for trend=0.12) were comparable in the 2 groups.\n            <\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p xml:lang=\"en\">The preventive use of verapamil may be unnecessary for transradial procedures. The omission of prophylactic verapamil may not only reduce the rate of potential complications related to the drug but also allow the safe extension of the transradial method to those with contraindications to verapamil.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec xml:lang=\"en\">\n            <jats:title>Clinical Trial Registration<\/jats:title>\n            <jats:p xml:lang=\"en\">\n              URL:\n              <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"http:\/\/www.clinicaltrials.gov\">http:\/\/www.clinicaltrials.gov<\/jats:ext-link>\n              . Unique identifier: NCT01402427.\n            <\/jats:p>\n          <\/jats:sec>","DOI":"10.1161\/jaha.113.000588","type":"journal-article","created":{"date-parts":[[2014,4,15]],"date-time":"2014-04-15T03:09:43Z","timestamp":1397531383000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":26,"title":["Need for Prophylactic Application of Verapamil in Transradial Coronary Procedures: A Randomized Trial"],"prefix":"10.1161","volume":"3","author":[{"given":"Istvan","family":"Hizoh","sequence":"first","affiliation":[{"name":"Department of Cardiology, Military Hospital, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zsuzsanna","family":"Majoros","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Military Hospital, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laszlo","family":"Major","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Military Hospital, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zalan","family":"Gulyas","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Military Hospital, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabor","family":"Szabo","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Military Hospital, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Gabor","family":"Kerecsen","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Military Hospital, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andras","family":"Korda","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Military Hospital, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ferenc","family":"Molnar","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Military Hospital, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert Gabor","family":"Kiss","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Military Hospital, Budapest, Hungary"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0735-1097(97)00064-8"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0002-8703(99)70143-2"},{"key":"e_1_3_3_4_2","first-page":"349","article-title":"Cost\u2010effectiveness of the radial versus femoral artery approach to diagnostic cardiac catheterization","volume":"19","author":"Roussanov O","year":"2007","unstructured":"Roussanov O, Wilson SJ, Henley K, Estacio G, Hill J, Dogan B, Henley WF, Jarmukli N. 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Radial artery spasm during transradial coronary procedures. J Invasive Cardiol. 2011;23:527\u2013531.","journal-title":"J Invasive Cardiol"},{"key":"e_1_3_3_14_2","first-page":"38","article-title":"Overcoming anatomic challenges to transradial access. An overview for interventionists who are considering transradial access training","author":"Pyne C","year":"2010","unstructured":"Pyne C, Mann T. Overcoming anatomic challenges to transradial access. An overview for interventionists who are considering transradial access training. Cardiac Interventions Today. 2010:38\u201340. Available at: http:\/\/bmctoday.net\/citoday\/2010\/04\/article.asp?f=overcoming-anatomic-challenges-to-transradial-access. Accessed August 13, 2013.","journal-title":"Cardiac Interventions Today"},{"key":"e_1_3_3_15_2","doi-asserted-by":"publisher","DOI":"10.4244\/EIJV8I11A192"},{"key":"e_1_3_3_16_2","unstructured":"Verapamil hydrochloride for intravenous injection; 2011. 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