Comparison of Standard Catheters Versus Radial Artery–Specific Catheter in Patients Who Underwent Coronary Angiography Through Transradial Access

Chen, On; Goel, Sunny; Acholonu, Michael; Kulbak, Guy; Verma, Shivani; Travlos, Efstratios; Casazza, Richard; Borgen, Elliot; Malik, Bilal; Friedman, Michael; Moskovits, Norbert; Frankel, Robert; Shani, Jacob; Ayzenberg, Sergey

doi:10.1016/j.amjcard.2016.05.010

Cited by 17 publications

(26 citation statements)

References 3 publications

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“…Use of Ca‐channel blockers was considerably more common in the US as compared to OUS interventionalists who preferred nitroglycerin. There is a slight but significant preference for universal diagnostic catheters in the US likely driven by less financial constraints and belief that these catheters will shorten procedure time …”

Section: Discussionmentioning

confidence: 99%

“…There is a slight but significant preference for universal diagnostic catheters in the US likely driven by less financial constraints and belief that these catheters will shorten procedure time. 20,21 Some of the variability between the US and OUS physicians may be related to device availability in each respondent's region. Sheath selection varied between the US and global operators, but most interventionalists chose 6 Fr catheter compatible sheaths for diagnostic and PCI procedures.…”

Section: Comparison To International Practice Survey From 2010mentioning

confidence: 99%

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Contemporary transradial access practices: Results of the second international survey

Shroff

Fernandez

Vidovich

et al. 2018

Cathet Cardio Intervent

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Objectives To gain insight into current practice of transradial angiography and intervention in the United States and around the world. Background Transradial access (TRA) has grown worldwide. In a prior survey, there was significant practice variation and there was minimal US participation which limited the generalizability to US operators. Methods We used an internet‐based survey software program to solicit input from practicing interventional cardiologists from the United States and around the world. US operators were compared with outside the United States (OUS) operators and respondent‐level comparisons were made with the prior survey to assess for temporal changes in practice. Results Between August 2016 and January 1, 2017, 125 interventional cardiologists completed the survey representing 91 countries with the United States having 449 (39.9%) respondents. Preprocedure, noninvasive testing for collateral circulation is used more commonly in the United States (54.1%) than around the world (26.6%) but its use has decreased since 2010. In the US, 48.8% of operators never use ultrasound and 92.6% of OUS operators never use it; only 4.4% overall use ultrasound in >50% of cases. Use of bivalirudin has decreased in the US and OUS. Nearly, 30% of operators do not assess for radial artery patency following hemostasis. US respondents used TRA less commonly for primary PCI for STEMI than their global counterparts. Conclusions There is wide variation in how TRA procedures are performed including relatively low rates of adherence to practices that are known to improve outcomes. Further education aimed at increasing use of best practices will impact patient outcomes.

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Section: Discussionmentioning

confidence: 99%

Section: Comparison To International Practice Survey From 2010mentioning

confidence: 99%

Contemporary transradial access practices: Results of the second international survey

Shroff

Fernandez

Vidovich

et al. 2018

Cathet Cardio Intervent

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“…Furthermore, there is expanding use of dedicated “multipurpose” radial catheters, which enable the operator to cannulate both coronary arteries, and also to perform chamber injection and left ventriculogram. For transradial procedures, this single-catheter approach has been shown to decrease radiation exposure, fluoroscopy time, contrast volume and total procedure time compared with standard Judkins catheters[2]. Using a single catheter also reduces the risk of spasm of the radial artery.…”

Section: Introductionmentioning

confidence: 99%

Inadvertent cardiac phlebography

Aznaouridis

Masoura

Kastellanos

et al. 2017

WJC

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We are reporting a case of a 80-year-old lady with effort angina who underwent coronary angiography through the right radial artery, using a dedicated radial multipurpose 5 French Optitorque Tiger catheter. The catheter was advanced into the left ventricle and a left ventriculogram was obtained, while the catheter appeared optimally placed at the centre of the ventricle and the pressure waveform was normal. A large posterior interventricular vein draining into the right atrium was opacified, presumably because the catheter’s end hole inadvertently cannulated an endocardial opening of a small thebesian vein, with subsequent retrograde filling of the epicardial vein. Our case suggests that caution is needed when a dedicated radial catheter with both an end-hole and a side hole is used for a ventriculogram, as a normal left ventricular pressure waveform does not exclude malposition of the end-hole against the ventricular wall.

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“…Operator radiation exposure, arguably more important than a patient's one-time procedural exposure, was not compared.Moreover, the work is unable to speak to the purported benefits of the single catheter approach, namely reducing arterial vasospasm by reducing catheter exchanges. While not highlighted by the authors, the procedure time was reduced in the single-catheter group by an average of two minutes, possibly outweighing any increase in patient radiation.Finally, the study did not test specially designed radial catheters such as the Jacky or Tiger catheters (Terumo, Somerset NJ) which have demonstrated benefits in small randomized studies [4,5].Observational data comparing single versus multiple catheters is unlikely to sway an operator who is comfortable, experienced, and successful with their preferred method. Randomized studies between the two methods may be too small to show a difference, or reveal an underlying preference of study operators.…”

mentioning

confidence: 99%

“…Finally, the study did not test specially designed radial catheters such as the Jacky or Tiger catheters (Terumo, Somerset NJ) which have demonstrated benefits in small randomized studies [4,5].…”

mentioning

confidence: 99%