الفهرس 
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Abstract
Coronary artery disease (CAD) has been considered one of the major causes of morbidity and mortality in developed countries but the rate of mortality decreased due to developing coronary angiography, as it become the gold standard for the diagnosis and treatment strategies for coronary artery disease that can be performed via the femoral, radial, or ulnar arteries. (1), (2)
The radial artery has become the preferred route for coronary angiography and interventions due to its safety, cost-effectiveness, short stay at the hospital, patient comfort in early ambulation and fewer complications are factors that make radial access more preferred. (3)
But the radial artery is a thick-walled vessel composed mainly of smooth muscle cells arranged in concentric layers. This marked muscular component of the artery and the high density of alpha-1 receptors make this vessel especially susceptible to spasms, so patients need proper sedation. (4)
This spasm remains the main problem we face during Trans radial coronary angiography, causing patient discomfort and reducing the procedure’s success rate. (5)
Variable factors were found associated with radial artery spasms such as Gender (female), angiographic characteristics of the radial artery (small radial artery diameter), clinical disorders (DM), and factors related to the procedure. (6)
So, patients will undergo coronary angiography or PCI should be evaluated for primary Trans radial access, through the palpation of adequate radial pulse volume and detect radial artery size for avoidance RAS. (7)
Summary
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Aim of Work:
We aim to compare radial artery diameter pre and post-radial coronary angiography by duplex ultrasound to evaluate the effect of pre-medication at the diameter of the radial artery and analyse the predictors that can cause radial artery spam (RAS) to avoid it.
Results
The mean age of patients was 52, the proportion of females is 64%, the proportion of hypertensive patients was 50%, the proportion of diabetic patients was 34%, the proportion of patients was 35%, the proportion of smokers was 35% and the patients who have previously had coronary interventional catheterization are 21%. The mean efficiency of the myocardium as measured by ventricular ejection fraction was 57. The proportion of patients who had a diagnostic catheterization performed only 52%, the proportion of patients had PCI with 1 DES were 28%, 18% who had 2 DES and 2% had 3 DES.
The incidence of radial artery spasm during coronary catheterization was 34%.
At comparing the cases that had spasm of the radial artery and those that did not, it was found that the cases of radial artery spasm were younger in age, the proportion of cases with a small body mass index was higher, the proportion of females was higher than the proportion of men, and smokers were higher in the incidence of the radial artery spasm, and the proportion of cases using beta-blocker drugs was less at the incidence of the radial artery spasm, and the cases in which there were multiple punctures of the radial artery to insert the radial sheath was higher, and the cases that were used with more stents were higher.