Efficacy and Safety of "Coronary Artery Bypass Graft Angiography" with Right Transradial Access versus Left Transradial Access and Femoral Access: a Retrospective Comparative Study

Abstract

Objective Over the past 10 years, the rate of patients who have undergone coronary artery bypass graft (CABG) surgery has increased twofold in cases of coronary angiography. Today, transradial access is the first choice for coronary angiography. We aimed to compare the efficacy and reliability of radial versus femoral access for coronary angiography in post-CABG surgery in this study. Methods Data from 442 patients who underwent post-CABG surgery between 2012-2017 were retrospectively compared. The right radial route was used in 120 cases, the left radial route in 148, and femoral route in 174. These three pathways were compared in terms of procedure time and fluoroscopy time, efficacy, and complication development. Comparisons among the three groups were performed with Bonferroni test for continuous variables and chi-square or Fisher's exact test for nominal variables as a binary. Results Comparison results indicate that femoral access was better than left radial access and the left radial access was better than right radial access in terms of fluoroscopy time (10.71±1.65, 10.94±1.25, 16.12±5.28 min, P <0.001) and total procedure time (17.28±1.68, 17.68±2.34, 23.04±5.84 min, P <0.001). The left radial pathway was the most effective way of viewing left internal mammary artery (LIMA). No statistically significant differences were found among the three groups in other graft visualizations, all minor complications, total procedure and fluoroscopy time " Except LIMA imaging ". Mortality due to processing was not observed in all three groups. Conclusion The left radial route is preferred over right radial access for post-CABG angiography because the left radial pathway is close to the LIMA and is similar to the femoral pathway. In LIMA graft imaging, right radial access is a reliable route, even though it is not as effective as other pathways. We hope that the right radial pathway will improve with physician experience and innovations.

Distal transradial access for post-CABG coronary and surgical grafts angiography and interventions

“…TFA was better than lsTRA, which was also better than rsTRA in terms of fluoroscopy time (10.71 ± 1.65, 10.94 ± 1.25, 16.12 ± 5.28 min, p < 0.001) and total procedure time (17.28 ± 1.68, 17.68 ± 2.34, 23.04 ± 5.84 min, p < 0.001) and lsTRA was the most effective way for LIMA angiography. 20 …”

Cardiac Catheterizations in Patients With Prior Coronary Bypass Surgery: Impact of Access Strategy on Short-Term Safety and Long-Term Efficacy Outcomes

“…However, in our study CABG anatomy was known in the great majority of patients presenting with STEMI and access site did not differ significantly in these patients if CABG anatomy was unknown. In addition, imaging the left internal mammary artery is more effective through TFA and left TRA than through right TRA, 20 but left TRA has its ergonomic disadvantages. 21 Furthermore, potential disadvantages of TRA, such as higher crossover rates might explain the preference for TFA.…”

Y90 Radioembolization of Liver Tumors via Radial approach – Correlation Between Common Femoral artery and Radial Artery Size

“…Physicians continue to become more precise and healthcare costs conscious which improves patient care [16,26]. What may seem now as a more di cult procedure, transradial artery procedures show greater promise over transfemoral artery procedures in a multitude of medical elds, from interventional oncology to cardiology [27][28][29]. Since medical infrastructure has been adapting from the traditional femoral artery approach to the newer transradial approach, our research hopes to further this advancement by providing an improved method to assess radial artery size based off of the preprocedure CT.…”