Abstract
BackgroundSeveral studies have implied that the time of radiation exposure for patients and operators during the transradial approach for coronary angiography (TRA) is associated with the use of different guidewire or catheter and operator’s finesse. This study aimed to assess the effects of non-hydrophilic or hydrophilic guidewire and operator expertise on fluoroscopy time and procedure time of TRA and further effects on the procedure safety.MethodsA total of 1035 consecutive patients undergoing TRA were recruited prospectively and respectively divided into non-hydrophilic guidewire and hydrophilic guidewire group, or well-experienced group and less-experienced group. The primary endpoints were fluoroscopy time and procedure time. Secondary endpoints included contrast volume, cost, guidewire exchange, switchover and complications.ResultsTRA by non-hydrophilic guidewire group showed shorter fluoroscopy time and procedure time compared with hydrophilic guidewire group, similar results were found between well-experienced group and less-experienced group. Moreover, using of non-hydrophilic guidewire significantly reduced the incidence of hematoma and abnormal guidewie advancement, well-experienced group showed less dosage of contrast volume, lower incidence of radial artery spasm and frequency of guidewire exchange.ConclusionsTRA by non-hydrophilic guidewire and well-experienced operator can decrease radiation exposure of patients and operators through reducing the fluoroscopy time and procedure time and further increase procedure safety. These will contribute to the optimization of TRA procedure and promote its widely application.Electronic supplementary materialThe online version of this article (doi:10.1186/s13019-014-0194-5) contains supplementary material, which is available to authorized users.
Highlights
Several studies have implied that the time of radiation exposure for patients and operators during the transradial approach for coronary angiography (TRA) is associated with the use of different guidewire or catheter and operator’s finesse
Zhao et al found that compared with hydrophilic coated guidewire, the successful use of PTCA guidewire followed with passage of diagnostic catheter resulted in straightening of the radial artery loop or radial artery tortuosity
Primary endpoints As the results showed,fluoroscopy time and procedure time were significantly shorter in non-hydrophilic guidewire group than those in hydrophilic guidewire group (3.8 [2.7-10.8] minutes vs. 4.3 [3.1-13.7] minutes; 19.2 [9–35] minutes vs. 21.2 [16–36] minutes, P < 0.001, respectively)
Summary
Several studies have implied that the time of radiation exposure for patients and operators during the transradial approach for coronary angiography (TRA) is associated with the use of different guidewire or catheter and operator’s finesse. Zhao et al found that compared with hydrophilic coated guidewire, the successful use of PTCA guidewire followed with passage of diagnostic catheter resulted in straightening of the radial artery loop or radial artery tortuosity. These may provide evidence that the optimization of guidewire or catheter can reduce the complications of TRA. The operator expertise has been reported to be related to the reduction of procedure time and radiation exposure [14], but there is still controversy on this view [6,12]
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