Abstract
BackgroundThe transradial approach (TRA) has already become popular worldwide, but only recently has gained acceptance among Iraqi interventional cardiologists. The aim of this study is to document single operator experience with TRA and to test the benefit of assessing dual hand circulation before the TRA. It was an observational prospective study. Over a 2-year period (Jan 1, 2015, to Dec 31, 2016), 1561 patients underwent transradial coronary angiography (CAG) and/or percutaneous coronary intervention (PCI) by a single operator. Patients were divided into two groups: A (the first 450 patients), in which dual hand circulation was assessed by Allen’s test or plethysmography/oximetry test before TRA, and B (1111 patients) in which TRA was done without assessing dual hand circulation.ResultsA total of 1561 patients were included, 69.1% males and 30.9% females. The mean age was (57 ± 10.0) years. We performed 1684 procedures (1005 CAG and 679 PCIs). The total transradial success rate was 95.6%, and PCI procedural success rate was 96.5%. The crossover rate from radial to femoral access was 4.4%. The primary causes for crossover were severe tortuosity of the aorta and brachiocephalic trunk, radial artery spasm, puncture failure, and radial loop. The main complication was radial artery occlusion (RAO) (3.7%). There were no cases of hand ischemia or complications that need surgical repair or blood transfusion. No statistically significant difference between groups A and B was observed regarding hand ischemia, the incidence of RAO, or the crossover rate.ConclusionsTRA is safe and can be applied in the majority of cases. The routine assessment of dual hand circulation before TRA might not be necessary.
Highlights
The transradial approach (TRA) has already become popular worldwide, but only recently has gained acceptance among Iraqi interventional cardiologists
TRA had been used as the preferred approach for coronary angiography (CAG) and percutaneous coronary intervention (PCI) for more than two decades across the world, its use in Iraq is still limited
In our center “Slemani Cardiac Hospital” (SCH), the TRA was started more than 6 years ago, and nowadays, more than 90% of coronary diagnostic and Aldoori and Mohammed The Egyptian Heart Journal (2019) 71:10 interventional procedures are done via the radial access
Summary
The transradial approach (TRA) has already become popular worldwide, but only recently has gained acceptance among Iraqi interventional cardiologists. The aim of this study is to document single operator experience with TRA and to test the benefit of assessing dual hand circulation before the TRA. Over a 2-year period (Jan 1, 2015, to Dec 31, 2016), 1561 patients underwent transradial coronary angiography (CAG) and/or percutaneous coronary intervention (PCI) by a single operator. TRA had been used as the preferred approach for CAG and PCI for more than two decades across the world, its use in Iraq is still limited. A few Iraqi cardiologists in few cardiac centers use the radial access as the default approach, while the majority of cardiologists still prefer the femoral access. SCH is the first public cardiac center in Sulaymaniyah, Iraq
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