Left Radial Approach versus Right Radial Approach of Coronary Angiography in the Diagnosis of Coronary Heart Disease

Pasupati Rajoria,Chenghong Xu,Keping Yang,Yunfeng Zhang,Wenjun Guan,Hua Yang

doi:10.4236/wjcd.2016.68030

Pasupati Rajoria, Chenghong Xu + Show 4 more

Open Access

https://doi.org/10.4236/wjcd.2016.68030

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Abstract

Background: Transradial coronary angiography has established itself as safe alternative to transfemoral approach. Today, the artery of approach lies completely on the operator’s choice. The Right Radial Approach (RRA) has been a favorite for most of the interventional cardiologists due to the convenience in operating from the right side. The Left Radial Approach (LRA) has always been a neglected route. LRA does have many advantages over the right, the vascular anatomy being one of them. The aim of our study was to compare the right radial approach of diagnostic coronary angiography with left radial approach. Method: A total of 70 cases of Coronary Angiography (CAG) with normal Allen test and satisfying the inclusion criteria were prospectively observed and studied after randomly assigning them into two equal groups, LRA (Left Radial Approach) n = 35 and RRA (Right Radial Approach) n = 35. Multipurpose TIG (Tiger) catheter was used in both the approaches to catheterize the right as well as left coronary artery. Results: The access time, catheter manipulation time, procedure time, amount of contrast used, hospital stay, intensity of pain experienced, cost of the procedure and quality of coronary angiogram observed were statistically insignificant while the fluoroscopy time was slightly statistically significant which was independent to catheter manipulation time. Conclusions: The neglected Left Radial Approach to coronary angiography is as efficacious, safe and cost effective with reduction in arterial spasm complications when compared to the Right Radial Approach performed by multipurpose Tiger catheter.

Highlights

The Coronary Angiography (CAG) is one of the minimally invasive diagnostic and therapeutic techniques used in patient with Coronary Heart Disease (CHD)
It involves the injection of a special contrast agent into the coronary arteries which is promptly detected by X-rays that further gives a series of image called the angiogram
Different parameters including access time, catheter manipulation time, procedure time, fluoroscopy time, total contrast agent used, hospital stay, pain experienced by the patients, complications and radial artery abnormalities were recorded and analyzed separately

Summary

Introduction

The Coronary Angiography (CAG) is one of the minimally invasive diagnostic and therapeutic techniques used in patient with Coronary Heart Disease (CHD) It involves the injection of a special contrast agent into the coronary arteries which is promptly detected by X-rays that further gives a series of image called the angiogram. Method: A total of 70 cases of Coronary Angiography (CAG) with normal Allen test and satisfying the inclusion criteria were prospectively observed and studied after randomly assigning them into two equal groups, LRA (Left Radial Approach) n = 35 and RRA (Right Radial Approach) n = 35. Conclusions: The neglected Left Radial Approach to coronary angiography is as efficacious, safe and cost effective with reduction in arterial spasm complications when compared to the Right Radial Approach performed by multipurpose Tiger catheter

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Results