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A randomized study comparing the effectiveness of right and left radial approach for coronary angiography
Author(s) -
Norgaz Tugrul,
Gorgulu Sevket,
Dagdelen Sinan
Publication year - 2012
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.23463
Subject(s) - medicine , fluoroscopy , radial artery , coronary angiography , dose area product , angiography , randomized controlled trial , population , nuclear medicine , artery , radiology , cardiology , surgery , myocardial infarction , environmental health
Objectives Our aim was to compare the effectiveness between right radial approach (RRA) and left radial approach (LRA) by means of a randomized study in a large unselected patient population undergoing diagnostic coronary angiography.Methods Totally, 1,000 patients were randomized to undergo to RRA ( n = 500) or LRA ( n = 500). Procedure success was defined as coronary angiography completed with the initial radial artery approach without changing to another route. Performance of the procedure: Total procedural duration, the number of catheters and guidewires used were recorded. Safety of the procedure: The parameters collected for radiation exposure were dose area product (DAP) and fluoroscopy time.Results The percentage of success was not different between the two aproaches (LRA, 94.0%; RRA,93.8%; P = 0.96). The crossover rate to femoral was low, accounting for 38 cases (3.8%), without differences between RRA and LRA (20 and 18 cases, respectively, P > 0.05). An almost triple incidence of operator‐reported subclavian tortuosity in the RRA compared with LRA was observed (44 cases vs. 15 cases, P < 0.001). With respect to the total procedural duration there was no difference between those two aproaches (LRA, 8.54 ± 4.09 min vs. RRA, 8.63 ± 5.20; P = 0.772). However, the fluoroscopy time was significantly shorter via the LRA compared with RRA (2.76 ± 2.00 min vs. 3.08 ± 2.62 min; P = 0.029).Conclusions LRA for coronary angiography is associated with the same success rate and procedural duration time compared with RRA. However, the fluoroscopy time is significantly shorter in favor of LRA. © 2012 Wiley Periodicals, Inc.