A prospective randomized comparison of left and right radial approach for percutaneous coronary angiography in Asian populations

Abstract

BackgroundThe efficacy of coronary angiography may be different in the right radial approach (RRA) and the left radial approach (LRA) due to more common vascular tortuosity in the RRA. The aim of the study was to determine whether LRA is a valid alternative for coronary angiography compared with RRA in Asian populations.MethodsThis is a single-center, prospective, randomized controlled study. A total of 1,400 consecutive patients undergoing diagnostic coronary angiography were recruited and randomized to the RRA (number [n]=700) or LRA (n=700) group. The primary end point was total procedural duration. Secondary end points included fluoroscopy time, dose of radiation including cumulative air kerma and dose area product, contrast volume, and the incidence of vascular complications.ResultsCoronary procedural success was achieved in 682 of 700 (97.4%) patients in the RRA and 680 of 700 (97.1%) in the LRA. The total procedural time (RRA 14.1±6.3 minutes versus LRA 13.2±6.0 minutes; P=0.006) and fluoroscopy time (RRA 3.8±3.3 minutes versus LRA 3.4±2.8 minutes; P=0.046) were significantly shorter via LRA in comparison to RRA. The percentage of hydrophilic wire use was also lower in the LRA group (14% [RRA] versus 10% [LRA]; P=0.016). The dose of radiation and contrast volume were not different between the two approaches. No cases of major bleeding and vascular complications requiring surgical intervention were reported, other than with one patient who experienced a symptomatic stroke and died in the RRA group compared with none in the LRA group.ConclusionThe LRA seems to be a feasible alternative for coronary angiography in Asian patients due to shorter procedural duration and fluoroscopy time, as well as less hydrophilic wire use in comparison to RRA.

Effectiveness of a handmade “New Carotid Catheter” in transradial carotid angiography: A comparison with conventional multipurpose catheters

“…However, with accumulating physician experience and advances in technology, transradial coronary angiography has become more preferred thanks to lower complication rates and increased physician and patient comfort. Even for primary PCI, the prevalently radial route has begun to be adopted …”

“…Even for primary PCI, the prevalently radial route has begun to be adopted. [1][2][3][4][5][6][7][8] Many publications have reported the safety of radial access in coronary angiography. In recent years, the duration of transradial angiography has decreased, and the radial approach has also become safely applicable for peripheral interventions.…”

Comparison of transradial coronary procedures via right radial versus left radial artery approach: A meta‐analysis

“…More recently, radial artery access is also linked to reduced mortality in comparison to femoral access in patients with acute myocardial infarction . There are a limited number of studies comparing the left versus right radial approach for coronary procedures . The right radial approach is traditionally favored by many operators, primarily because of associated ease with the standard access setup .…”

‘New Developed Femoral-S Carotid Catheter’ is Very Effective and Safe in Carotid Angiography: A Retrospective Study

“…Therefore, the first preferred route for carotid angiography is the femoral way. New catheter development is needed for physicians to making easier and safer carotid imaging with femoral way [19][20][21][22][23][24][25][26].…”