Our experience with transradial approach for coronary angiography

Transradial approach (TRA) for coronary angiography has only become popular in our country in recent years. In this study, we evaluated radial and femoral angiographies performed at our center.

A total of 487 patients (351 males, 136 females) were scheduled for coronary angiography using TRA in 2007. Data regarding the procedure were compared with those of 500 patients (369 males, 131 females) who underwent coronary angiography via the transfemoral approach (TFA). All the procedures were performed by the same experienced cardiologist. Coronary angiography from the radial artery was performed after a positive Allen test and a careful physical examination of the access site. A 100-cm Optitorque radial catheter was mostly used to cannulate both right and left coronary arteries. Transfemoral catheterization was performed using 6 Fr diagnostic catheters, usually Judkins curve catheters.

Procedural success rates were 96.5% (n=470) and 98.4% (n=492) in the TRA and TFA groups, respectively (p>0.05). The two groups were similar with respect to the procedural variables, except for the access time which was slightly higher in the TRA group (p<0.01). A higher incidence of coronary slow flow was detected in the TRA group (p<0.01). In 423 patients (90.0%), a single catheter was used for both selective right and left coronary angiography in the TRA group, resulting in a significantly lower number of catheter use (2.1+/-0.2 vs 3.2+/- 03; p<0.001). Only minor complications were seen during TRA, most commonly being pain and ecchymoses. In the TFA group, 27 patients (5.4%) developed hematoma at the access site, of more than 5 cm in diameter. Hospital stay was significantly shorter in the TRA group (2.1+/-0.4 hr vs 6.7+/-1.0 hr; p<0.001).

Transradial coronary angiography is a good alternative to TFA and can be performed safely and effectively in eligible patients.