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Coronary angiography and angioplasty using the aberrant radial artery as an access site
Rajpal K Abhaichand1, K A Sambasivam, P R Vydianathan
1G. Kuppuswamy Naidu Hospital, Cardiology Department, Coimbatore, India.
Objective:
To study the suitability of the aberrant radial artery (ARA) as an access site for coronary angiography and angioplasty.
Background:
In certain situations, the radial artery operator finds that the right radial artery in its usual location is unsuitable for a transradial procedure (TRP). In such cases, the ARA should be considered as an alternate access site.
Methods:
Between January 2002 and December 2004, all patients considered suitable for a TRP with a clinically absent radial artery, or a small radial artery and a palpable ARA, underwent a TRP using this vessel as an access site. We describe the technical aspects and the differences that this approach entails, in comparison to the standard radial artery approach to TRPs.
Results:
Of the 3,610 patients considered suitable for a TRP, 22 patients underwent 29 procedures using the ARA as an access site [22 angiograms and 7 percutaneous transluminal coronary angioplasty procedures (PTCAs)]. The median age of the patients was 55 years, with 19 males and 3 females. All procedures using the aberrant radial artery were successful. None of the patients developed spasm or an access site complication. The mean fluoroscopy time for angiography in the right radial artery group was 4.6 minutes, and 4.8 minutes for the ARA group. The procedure timed were 24 minutes and 32 minutes, respectively.
Conclusion:
The aberrant radial artery can be used as a safe alternate access site for coronary angiography and angioplasty when the right radial artery at the usual site is not suitable.
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Assessment of apical radial pulse
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation
Assessment of radial pulse
The radial pulse, located at the wrist, is often the preferred site for assessing peripheral pulse because of its accessibility and dependability. The process of determining the radial pulse involves several steps:

