One or two diagnostic catheters with radial access: Does single yield celerity or double cause trouble?

Area of Science:

• Cardiology
• Interventional Cardiology
• Medical Devices

Background:

• Radial access is increasingly preferred for coronary angiography.
• A single "universal" catheter strategy is proposed as superior to using dedicated left and right coronary catheters.
• Current practice shows one-third of interventionalists still use dedicated catheters.

Discussion:

• This meta-analysis compared one- versus two-catheter strategies in seven randomized controlled studies.
• Key procedural metrics including procedural time, fluoroscopy time, and contrast volume were analyzed.
• The analysis focused specifically on diagnostic angiography performed via radial artery access.

Key Insights:

• No statistically significant differences were observed in procedural time, fluoroscopy time, or contrast use between the one- and two-catheter strategies.
• Increased use of an additional catheter was noted with the one-catheter strategy.
• A higher incidence of radial artery spasm was associated with the two-catheter strategy.

Outlook:

• Future research should investigate cost-effectiveness and complication rates, including radial occlusion.
• Long-term outcomes and patient safety associated with each catheter strategy require further evaluation.
• Evidence regarding the superiority of a single "universal" catheter strategy remains inconclusive based on current procedural metrics.