Comparative analysis of cerebral angiography via right versus left radial artery approaches

The use of right transradial approach (TRA) in cerebral angiography has been mature, but it is still limited by anatomical variation of the right radial artery or left-sided vertebral artery lesions. This study aimed to compare outcomes between right and left TRA for cerebral angiography and evaluate the safety of left TRA.

The study cohort comprised 80 patients who underwent cerebral angiography via TRA. The patients' clinical data were analyzed retrospectively. Bilateral proximal and distal radial artery diameters were measured preoperatively using ultrasonography. Puncture site complications and radial artery patency were assessed using ultrasonography 1 day postoperatively. Hand ischemia was followed up by telephone or in clinic 30 days postoperatively.

The overall procedural success rate was 92.5% (74/80); 92.0% (46/50) in the right TRA group and 93.3% (28/30) in the left TRA group, with no significant differences between the groups (p > 0.05). Left TRA was associated with a significantly longer procedure time compared with right TRA in the secondary outcomes (35.50 ± 15.62 min vs. 45.50 ± 16.04 min, respectively; p = 0.008). Linear regression analysis adjusted for confounders confirmed this difference (mean difference: 8.516 min; 95% CI, 1.178-15.853; p = 0.024). No hand ischemia events occurred during ultrasonography and follow-up.

We found no significant differences in the safety and efficacy of cerebral angiography performed via right vs. left TRA. Left TRA can be applied to anatomical variations of the right radial artery or to treat left-sided vertebral artery lesions.