Abstract 16795: Comparison of Success Rate, Procedural Factors, and Radiation Exposure for Coronary Angiography Between Right and Left Radial Approach: Korea Transradial Coronary Intervention Prospective Registry (KOTRI)

Abstract

Introduction: The use of radial artery is gradually increasing because transradial approach have shown less mortality and bleeding complications compared to transfermoral approach. But, there is little known about the differences according to radial access site except for fluoroscopic time and learning curve. Hypothesis: We aimed to compare the success rate, procedural factors and radiation exposure according to radial access site in patients who performed coronary angiography (CAG). Methods: The study population was derived from TRI prospective registry from 20 institutes in Korea from Feb 2013 to Sep 2013. Exclusion criteria were patients with data missing≥30%, invalid data, less than 19-year old patients, patient received interventional treatment, and patient who performed CAG via femoral approach. A total of 3496 among 5779 patients was assessed for data analysis. Success rate for CAG, crossover rate, procedural factors, fluoroscopic time and fluoroscopic dose were compared between right radial (RR) and left radial (LR) approach. Results: Mean age was 62.9±11.6 years and male was 1974 patients (56.5%). The use or EMLA cream was higher in LR group (29.2% vs. 14.0%, p<0.001). CAG with single catheter was similar between RR and LR group (14.5% vs. 15.1%, p=0.652). Success rate for CAG was higher in RR group (99.4% vs. 98.1%, p=0.001). Crossover rate was higher in LR group (1.9% vs. 0.6%, p<0.001). Most common cause for crossover was puncture failure 0.3% vs. 1.2%, p=0.002). Puncture time and CAG time were faster in LR group (2.1±2.7 mins vs. 2.5±3.0 mins, p<0.001; 104±7.4 mins vs. 11.3±8.7 mins, p=0.003). LR group showed lower fluoroscopic time, dose (3.5±3.6 mins vs. 4.9±6.6 mins, p<0.001 ; 37.5±47.8 Gycm2 vs. 41.1±42.2 Gycm2, p<0.001) and higher total contrast volume (84.8±41.1 mL vs. 77.4±33.9 mL, p<0.001). Conclusions: In KOTRI analysis, success rate for CAG was higher in RR group, but radiation time and dose were lower in LR group. Most common cause of crossover was puncture failure.