Response to Letter by Pristipino and Hamon Regarding Article, “Cerebral Microembolism During Coronary Angiography: A Randomized Comparison Between Femoral and Radial Arterial Access”

Abstract

Response: We thank Drs Pristipino and Hamon1 for taking notice of our report2 and appreciate their comments. Regarding comment 1: The transradial technique is indeed more demanding. The 2 participating interventionalists were experienced. The longer fluoroscopy time with the radial access in our study was largely in accordance with the normal range reported in Dr Hamons' work published in 2007.3 Crossover from the radial to the femoral access occurred more often than anticipated. Underlying causes differed: narrow radial artery, anatomic anomaly of the right coronary artery, hypotensive reactions probably caused by medication against radial artery spasm, and unsuccessful selective angiography of the left coronary artery in which case the interventionalists changed access site rather than trying multiple catheters to avoid …