Abstract
ObjectiveOver the past 10 years, the rate of patients who have undergone coronary artery bypass graft (CABG) surgery has increased twofold in cases of coronary angiography. Today, transradial access is the first choice for coronary angiography. We aimed to compare the efficacy and reliability of radial versus femoral access for coronary angiography in post-CABG surgery in this study.MethodsData from 442 patients who underwent post-CABG surgery between 2012-2017 were retrospectively compared. The right radial route was used in 120 cases, the left radial route in 148, and femoral route in 174. These three pathways were compared in terms of procedure time and fluoroscopy time, efficacy, and complication development. Comparisons among the three groups were performed with Bonferroni test for continuous variables and chi-square or Fisher's exact test for nominal variables as a binary.ResultsComparison results indicate that femoral access was better than left radial access and the left radial access was better than right radial access in terms of fluoroscopy time (10.71±1.65, 10.94±1.25, 16.12±5.28 min, P<0.001) and total procedure time (17.28±1.68, 17.68±2.34, 23.04±5.84 min, P<0.001). The left radial pathway was the most effective way of viewing left internal mammary artery (LIMA). No statistically significant differences were found among the three groups in other graft visualizations, all minor complications, total procedure and fluoroscopy time "Except LIMA imaging". Mortality due to processing was not observed in all three groups.ConclusionThe left radial route is preferred over right radial access for post-CABG angiography because the left radial pathway is close to the LIMA and is similar to the femoral pathway. In LIMA graft imaging, right radial access is a reliable route, even though it is not as effective as other pathways. We hope that the right radial pathway will improve with physician experience and innovations.
Highlights
Transradial coronary angiography has recently been widely used in place of post-coronary artery bypass graft (CABG) imaging since 2010 in Europe and the larger cities of Turkey
The left radial route is preferred over right radial access for post-CABG angiography because the left radial pathway is close to the left internal mammary artery (LIMA) and is similar to the femoral pathway
In studies related to coronary angiography and percutaneous intervention that were conducted in recent years, transradial access has left its disadvantage in terms of time and performance relative to the transfemoral route, and advantageous in terms of complications[3,4,5]
Summary
Transradial coronary angiography has recently been widely used in place of post-coronary artery bypass graft (CABG) imaging since 2010 in Europe and the larger cities of Turkey. In studies related to coronary angiography and percutaneous intervention that were conducted in recent years, transradial access has left its disadvantage in terms of time and performance relative to the transfemoral route, and advantageous in terms of complications[3,4,5]. Radial access has been used for the purpose of carotid and renal artery angiography[6,7,8], transradial access has been used for acute ischemic stroke intervention[9], but femoral access is still advantageous from the point of view of the radiation exposure dose of the operator[10]. The first preference of cardiologists who have used the radial route for the first time is left transradial access for performing coronary.
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