Randomized comparison of transradial coronary angiography via right or left radial artery approaches

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Access

Background:

• Previous research indicated greater tortuosity with the right radial approach compared to the left during transradial coronary angiography.
• The advent of dedicated transradial catheters may influence the procedural difficulty associated with each approach.

Purpose of the Study:

• To compare the procedural difficulty between the right and left radial artery approaches in the current era of interventional cardiology.
• To evaluate the efficacy and feasibility of both radial approaches using modern dedicated transradial catheters.

Main Methods:

• A randomized controlled trial involving 193 patients undergoing transradial coronary angiography.
• Patients were randomized to either the right or left radial artery approach, with a preference for dedicated transradial Optitorque catheters.
• Procedural difficulty was assessed based on specific criteria including wire use, catheter exchanges, and injection selectivity.

Main Results:

• High procedural success rates were observed in both groups: 98% for the right radial approach and 99% for the left radial approach.
• No significant differences were found in procedural difficulty, fluoroscopy time, or contrast agent utilization between the two groups.
• The use of a single catheter was significantly more frequent in the right radial group (73%) compared to the left radial group (18%).

Conclusions:

• Both right and left radial artery approaches are equally feasible and effective for performing coronary angiography and interventions.
• Procedural success and difficulty are comparable between the right and left radial approaches when using dedicated transradial catheters.