The Effect of Topical Diltiazem on Radial Artery Cannulation Success in Coronary Angiography

Objectives: Radial artery cannulation for coronary angiography has become the preferred approach due to its association with reduced complications and faster recovery times compared to femoral artery access. However, the procedure can still pose challenges, particularly in patients with small or spastic arteries. This study aims to assess the impact of applying topical diltiazem cream on radial artery dilation, cannulation success, puncture time, and complication rates in patients undergoing coronary angiography. Methods: There were 57 patients included in the study, of whom 29 were topically treated with 2% diltiazem before radial puncture and 28 were not. 2.5 cm length of cream squeezed was applied for standardization based on manufacturer’s suggestion. Results: The mean age of the patients was 59.1±10.2 in the control group and 58.3±9.5 in the study group (p>0.05). The gender and comorbidities of the patients were statistically comparable. The study group achieved an 86.2% (25/29) success rate in first-attempt cannulation, compared to 67.9% (19/28) in the control group (p=0.038). The mean time required for puncture was significantly shorter in the study group (41.8±7.9 s) than in the control group (56.7±9.8 s) (p=0.031). The complication rates were low and similar among groups. Conclusion: Topical diltiazem cream application may significantly improve radial artery cannulation success and reduces puncture time while decreasing complication rates in patients undergoing coronary angiography.