Retrospective Study of Success Rate of Right Radial Artery Access for Coronary Angiography in a Cardiac Catheterization Laboratory with Operators Inexperienced in Radial Access

Abstract

BACKGROUNDCoronary angiography (CAG) is the most common procedure done in a cardiac catheterization lab (cathlab). In the last decade, the preferred access has changed to radial from femoral artery. CAG via radial route is believed to have a long learning curve. We wanted to assess the success rate of right radial route for CAG and its improvement over one year for operators inexperienced with the radial route. METHODSA retrospective study over one-year period from June 1, 2017 to 31 May 2018 involving 1011 CAGs was done. First 150 CAGs were compared with 150 CAGs done at end of first year. Demographic variables of patients, arterial access for CAG, fluoroscopy time, number of cine angios recorded and radiation dose of cinerecording were compared. Qualitative data was analysed using Chi Square test, quantitative data using independent t test and correlation done using Pearson correlation. RESULTSDemographic variables were comparable between the two groups. CAG was completed successfully in 88.7% (133/150) via right radial artery in first group and in 92.7% (139/150) in second group (p<0.05). There was significant reduction of 1.8 minutes in mean fluoroscopy time between the two groups (6.5 vs. 4.7 minutes p<0.001). A positive correlation was noted between total radiation dose and number of cine films recorded in both groups. CONCLUSIONSCAG via right radial route can be done with good success rate even by inexperienced operators. The success rate improves, and fluoroscopic time decreases over time. By reducing the number of cine recordings total radiation dose can be brought down.