Comparison between left and right radial access for coronary angiography
Main Article Content
Abstract
In the 1980s, Campeu and Kiemeneij introduced the radial approach for angiography and angioplasty, respectively, in 2017 Kiemeneij described the site of radial distal access to the snuffbox, as the viability and safety of the left approach, either conventional or distal, remains a concern and there are no studies evaluating comfort yet.
We randomly assigned 55 patients (9 were excluded), to either left radial access or right radial access (27 pts vs 28 pts). The primary end point was patient´s comfort, contrast volume, distance between first operator and patient, number of angiography catheters, fluoroscopy time. As secondary safety endpoints we include radial spasm and procedure related bleeding. Statistical analysis was done with descriptive statistics, T student for quantitative variables and square chi for qualitative variables.
From January 2019 to September 2019 we enrolled 64 patients, (9 were excluded) Stable coronary artery disease was the most common indication for angiography (60% left vs 43% right). Both access were perceived as comfortable (4.29 left vs 4.18 right P=0.549), the amount of contrast volume used was (103 + 85 ml vs 88+55 ml P=0.436, distance between intensifier-researcher (47.6 cm +4.6 right vs 47.7cms +4.8 left, p = 0.941). In safety endpoints the presence of bleeding was 7% vs 7% (P=0.99) and radial artery spasm 26% and 11% respectively (P=0.177).
In terms of comfort and safety there is no difference between left and right radial access, both access sites can be done with femoral and radial dedicated catheters in stable coronary disease and acute coronary syndrome coronary.
Downloads
Article Details
Copyright (c) 2020 Cázares-Díazleal AC, et al.
This work is licensed under a Creative Commons Attribution 4.0 International License.
Licensing and protecting the author rights is the central aim and core of the publishing business. Peertechz dedicates itself in making it easier for people to share and build upon the work of others while maintaining consistency with the rules of copyright. Peertechz licensing terms are formulated to facilitate reuse of the manuscripts published in journals to take maximum advantage of Open Access publication and for the purpose of disseminating knowledge.
We support 'libre' open access, which defines Open Access in true terms as free of charge online access along with usage rights. The usage rights are granted through the use of specific Creative Commons license.
Peertechz accomplice with- [CC BY 4.0]
Explanation
'CC' stands for Creative Commons license. 'BY' symbolizes that users have provided attribution to the creator that the published manuscripts can be used or shared. This license allows for redistribution, commercial and non-commercial, as long as it is passed along unchanged and in whole, with credit to the author.
Please take in notification that Creative Commons user licenses are non-revocable. We recommend authors to check if their funding body requires a specific license.
With this license, the authors are allowed that after publishing with Peertechz, they can share their research by posting a free draft copy of their article to any repository or website.
'CC BY' license observance:
License Name |
Permission to read and download |
Permission to display in a repository |
Permission to translate |
Commercial uses of manuscript |
CC BY 4.0 |
Yes |
Yes |
Yes |
Yes |
The authors please note that Creative Commons license is focused on making creative works available for discovery and reuse. Creative Commons licenses provide an alternative to standard copyrights, allowing authors to specify ways that their works can be used without having to grant permission for each individual request. Others who want to reserve all of their rights under copyright law should not use CC licenses.
Forssmann W (1929) Die Sondierung des rechten Herzens. Klin Wochenschr 8: 2085–2087. Link: https://bit.ly/2VJWrld
Regato JA (1951) In Memoriam: Pedro L. Farinas, MD (1892-1951). Radiology 57: 110-111. Link: https://bit.ly/2NTQNIQ
Seldinger SI (1953) Catheter replacement of the needle in percutaneous arteriography; a new technique. Radiol Acta 39: 368–376. Link: https://bit.ly/31EqqyG
Fogarty TJ, Daily PO, Shumway NE, Krippaehne W (1971) Experience with balloon catheter technique for arterial embolectomy. Am J Surg 122: 231-237. Link: https://bit.ly/2VCFKrZ
Dotter CT, Judkins MP (1964) Transluminal treatment of arteriosclerotic obstruction. Description of a new technique and a preliminary report of its application. Circulation 30: 654-670. Link: https://bit.ly/2ZBHR0n
Grüentzig AR, Senning Å, Siegenthaler WE (1979) Nonoperative dilatation of coronary-artery stenosis: percutaneous transluminal coronary angioplasty. N Engl J Med 301: 61-68. Link: https://bit.ly/38lIvTI
Grier D, Hartnell G (1990) Percutaneous femoral artery puncture: practice and anatomy. Br J Radiol 63: 602-604. Link: https://bit.ly/3goevJu
Kiemeneij F, Laarman GJ, Odekerken D, Slagboom T, van der Wieken R (1997) A randomized comparison of percutaneous transluminal coronary angioplasty by the radial, brachial and femoral approaches: the access study. J Am Coll Cardiol 29: 1269-1275. Link: https://bit.ly/2NU2KhY
Campeau L (1989) Percutaneous radial artery approach for coronary angiography. Cathet Cardiovasc Diagn 16: 3-7. Link: https://bit.ly/31FHapn
Kiemeneij F, Laarman GJ, de Melker E (1995) Transradial artery coronary angioplasty. Am Heart J 129: 1-7. Link: https://bit.ly/3dWvlh4
Kiemeneij F (2017) Left distal transradial access in the anatomical snuffbox for coronary angiography (ldTRA) and interventions (ldTRI). EuroIntervention 13: 851-857. Link: https://bit.ly/31HIPdV
Hadjivassiliou A, Kiemeneij F, Nathan S, Klass D (2019) Ultrasound-guided access of the distal radial artery at the anatomical snuffbox for catheter-based vascular interventions: A technical guide. EuroIntervention. Link: https://bit.ly/2ZxDd3s
Kim Y, Ahn Y, Kim I, Lee D, Kim H, Sim DS, et al. (2018) Feasibility of coronary angiography and percutaneous coronary intervention via left snuffbox approach. Korean Circ J 48: 1120-1130. Link: https://bit.ly/31KcGm7
Mizuguchi Y, Izumikawa T, Takahashi A, Yamada T, Taniguchi N, et al. (2018) TCT-846 Multicenter Study of the Efficacy and Safety of Distal Radial Approach in Coronary Angiography and Intervention. JACC 72. Link: https://bit.ly/2ZyePP9
Koutouzis M, Kontopodis E, Tassopoulos A, Tsiafoutis I, Lazaris E (2018) Hand Hematoma After Cardiac Catheterization Via Distal Radial Artery. J Invasive Cardiol 30: 428-428. Link: https://bit.ly/2VJjHjf