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A Comparison of Image Quality Using Radial vs Femoral Approaches in Patients Undergoing Diagnostic Coronary

Wallace W K Chow, Rong Bing, Juliana Kanawati

  • 1Cardiology Department, Concord Hospital, The University of Sydney, Hospital Road, Concord 2139, NSW, Australia. david.brieger@health.nsw.gov.au.

The Journal of Invasive Cardiology
|August 16, 2018
PubMed

Insights

Radial access for coronary angiography yields poorer image quality and higher radiation doses compared to femoral access. These findings are crucial for selecting the optimal access method in patients undergoing diagnostic procedures.

Area of Science:

  • Cardiovascular Imaging
  • Interventional Cardiology

Background:

  • Radial access is increasingly used for diagnostic coronary angiography (CAG).
  • Limited studies have compared image quality between radial and femoral approaches.

Purpose of the Study:

  • To compare angiographic image quality and diagnostic value between radial and femoral access in CAG.
  • To evaluate the proportion of non-diagnostic images and patient radiation dose for each access method.

Main Methods:

  • Retrospective analysis of 200 patients (100 radial, 100 femoral) undergoing CAG.
  • Image quality assessed quantitatively by four experienced angiographers.
  • Comparison of primary endpoint (image quality) and secondary endpoints (non-diagnostic images, radiation dose).

Main Results:

  • Radial access resulted in significantly poorer image quality for the left coronary artery compared to femoral access (P<.01).
  • A higher proportion of non-diagnostic images (3.23% vs 2.02%) and increased patient radiation doses (832.81 mGy vs 645.69 mGy) were observed with radial access.
  • No significant difference in image quality was found for the right coronary artery between the two groups.

Conclusions:

  • Radial access is associated with inferior angiographic image quality and higher radiation exposure than femoral access.
  • Awareness of these limitations is vital for informed decision-making in selecting the access route for diagnostic CAG.
Abstract

Keywords:
CAGcoronary angiographyimage qualityradial access

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