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Published on: September 20, 2020
A Comparison of Three Commonly Used Catheter Strategies in Diagnostic Transradial Coronary Angiography
Jesse A Kane1, Ian Gilchrist2, Andreas Kalogeropoulos2
1Division of Cardiology, Department of Medicine, University of Vermont Medical Center, Burlington, Vermont.
Insights
The Tiger catheter significantly reduced contrast volume and procedure time during transradial coronary angiography compared to Judkins and Jacky catheters. This study highlights the Tiger catheter
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- The transradial approach is standard for coronary angiography.
- Limited research compares Tiger, Jacky, and Judkins catheters for transradial coronary angiography.
- This study evaluates three common catheter strategies.
Purpose of the Study:
- To compare the procedural performance of Tiger, Jacky, and Judkins catheters in transradial coronary angiography.
- To assess differences in procedure time, contrast volume, and fluoroscopy time.
Main Methods:
- A single-center, randomized trial allocated 99 patients 1:1:1 to Tiger (T), Jacky (JA), or Judkins (JU) initial strategies.
- Elective right transradial coronary angiography was performed by experienced operators.
- Primary endpoints were procedure time, contrast volume, and fluoroscopy time.
Main Results:
- The Tiger group used significantly less contrast volume (40ml) than JA (50ml) and JU (55ml) groups (P=0.04).
- Total procedural time was significantly lower in the Tiger group (9.2 min) compared to JA (11.92 min) and JU (12.8 min) groups (P=0.003).
- No significant difference in fluoroscopy time was observed between the groups (P=0.08).
Conclusions:
- The Tiger catheter demonstrates superior procedural efficiency in terms of reduced contrast volume and procedure time for transradial coronary angiography.
- Catheter choice impacts procedural outcomes, suggesting potential for optimization with the Tiger catheter.
- Further research may explore broader adoption of the Tiger catheter in clinical practice.
Abstract:
The transradial technique has become standard of care for coronary angiography and intervention. In the field of diagnostic coronary angiography, studies have compared single and dual catheter approaches, yet there is paucity of literature comparing all 3 commonly used strategies for transradial coronary angiography, Judkins (JU) dual catheters or single Tiger (T) or Jacky (JA) catheters. We aimed to assess the procedural performance of 3 commonly used catheter strategies. We conducted a single-center, randomized trial with 1:1:1 group allocation (T, JA, and JU as initial strategy) with patients undergoing elective right transradial coronary angiography performed by experienced operators. Primary endpoints included procedure time, contrast volume, and fluoroscopy time. A total of 99 patients were randomized: 33 were enrolled in the T-study group, 33 in the JA group, and 33 in the JU group. Median contrast volume utilization was significantly lower in the T group relative to the other groups ([T: 40 mL {35 to 50 mL}, JA: 50 mL {40 to 59 mL}, JU: 55 mL {45 to 60 mL}, p = 0.04]). The Tiger group was noted to have significantly lower times total procedural time (T: 9.2 minute [6.92 to 11.3 minute], JA: 11.92 minute [8.2 to 17.57 minute], JU: 12.8 minute [10.3 to 15.58 minute], p = 0.003). However, there was no difference in fluoroscopy time (T: 2.8 minute [2.17 to 5.6 minute], JA: 4.35 minute [2.7 to 7.43 minute], JU: 4.3 minute [3.1 to 7.1 minute], p = 0.08).
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