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Left radial versus right radial approach for coronary artery catheterization: a prospective comparison

Marcello Dominici1, Roberto Diletti, Caterina Milici

  • 1Division of Cardiology, Santa Maria University Hospital, Terni, Italy.

Journal of Interventional Cardiology
|January 26, 2012
PubMed

Insights

The left radial approach for coronary angiography is safe and feasible, reducing procedure time and catheter use compared to the right radial approach. This method offers advantages in daily practice for cardiac interventions.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Access

Background:

  • Transradial access for coronary interventions offers advantages but has low adoption due to technical challenges with the right radial artery.
  • The left radial approach presents potential anatomical benefits for vascular access.
  • This study aimed to assess the safety and feasibility of routine left radial versus right radial access.

Purpose of the Study:

  • To compare the safety and feasibility of left radial artery access versus right radial artery access for coronary artery catheterization.
  • To evaluate clinical outcomes and procedural efficiency between the two radial approaches.

Main Methods:

  • Prospective, single-center study comparing left radial and right radial access for coronary angiography.
  • Assessment of in-hospital major adverse cardiac and cerebral events (MACCE), procedural success, bleeding, vascular complications, fluoroscopy time, catheter utilization, and contrast volume.

Main Results:

  • 1,032 coronary angiograms performed (420 right radial, 612 left radial).
  • No significant differences in MACCE or procedural success rates between groups.
  • Left radial access showed significantly reduced fluoroscopy time and fewer catheters used (P < 0.01).
  • No major bleeding or vascular complications requiring surgery were reported; contrast volume was similar.

Conclusions:

  • The left radial approach is safe and feasible for routine use in daily practice for coronary interventions.
  • Left radial access is associated with improved procedural efficiency, indicated by reduced fluoroscopy time and catheter usage.
Abstract

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