This randomized, double-blind, controlled trial aims to evaluate the effect of preprocedural hand exercise using a stress ball on the incidence of radial artery spasm and other vascular complications in patients undergoing elective coronary angiography via the transradial approach. A total of 400 adult patients scheduled for elective diagnostic or interventional coronary procedures will be randomly assigned to either an intervention group (preprocedural stress ball exercise) or a control group (standard care). The intervention group will perform hand exercises with a soft stress ball for 5 minutes, three times daily, for three consecutive days prior to the procedure.
The primary outcomes are the incidence of radial artery spasm during the procedure and the overall rate of radial artery complications.
Secondary outcomes include patient-reported pain score (visual analog scale) during the procedure and the incidence of radial artery occlusion at 7 days, assessed by Doppler ultrasonography.
This study aims to determine whether this simple, low-cost strategy can reduce radial artery-related complications and improve patient comfort during transradial coronary procedures.
Age between 18 and 85 years
Elective radial coronary angiography planned
Written informed consent provided
Ability to understand and comply with the stress ball exercise protocol (3×5 minutes/day for 3 days prior to procedure)
Emergent or urgent coronary procedures
Known radial artery occlusion or non-palpable radial pulse on the intended access side
Prior arteriovenous fistula or vascular surgery in the ipsilateral arm
History of Raynaud's disease, severe peripheral artery disease, or Buerger's disease
Parallel
Stress Ball Use
BehavioralParticipants will perform hand exercises using a rubber stress ball for 5 minutes, 3 times daily, for 3 days prior to radial angiography.
Radial Artery Spasm Rate
Incidence of periprocedural radial artery spasm as reported by the operator, characterized by catheter resistance, patient discomfort, or vasodilator need.
Pain Score During Procedure (VAS)
Visual Analog Scale (VAS) score reported by the patient (0 = no pain, 10 = worst pain imaginable).
Radial Artery Occlusion (RAO)
Radial artery occlusion confirmed by color Doppler ultrasonography. RAO is defined as the absence of flow in the radial artery at the puncture site, assessed in both longitudinal and transverse views.
Radial Artery Cannulation Duration
Total time from radial sheath insertion, measured in minutes.
Number of Puncture Attempts
Number of needle punctures required for successful access.
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