Use of viperslide lubricant to extract entrapped sheath: After severe radial artery spasm during coronary angiography

Abstract

Radial artery spasm is a known complication of transradial cardiac catheterization. However, severe spasm with sheath entrapment is rare. We describe such a case, and the condition’s response to an alternative removal method after conventional efforts failed. A 68-year-old man presented for coronary angiography. We introduced a 5F sheath into the right radial artery, but, because of severe arterial spasm, we could not aspirate blood from the sheath or retract it. We sedated the patient and waited for the spasm to subside; however, the radial sheath remained entrapped. Nitroglycerin injection enabled blood aspiration and vasodilator injection, but not sheath removal. Finally, we injected ViperSlide lubricant into the sheath for its rapid, easy extraction. When sedation and vasodilator therapy fail, we recommend using ViperSlide for radial sheath removal before applying nerve block or general anesthesia.