Safety and efficacy of a multipurpose coronary angiography strategy using the transradial technique.

UNLABELLED: The use of a single catheter for coronary angiography has a number of potential advantages such as the reduction of arterial trauma, costs and procedural time. Accordingly, we assessed the feasibility and safety of two different strategies for transradial multipurpose coronary angiography.

METHODS: From February 2002 to December 2004, a total of 657 transradial diagnostic catheterizations were performed by a single operator in which engagement of both left and right coronary arteries was attempted either with a Judkins Left 3.5 (n = 194) or a Brachial Type K (n = 463) catheter. Success rates and complications were analyzed.

RESULTS: The mean age was 64.4 +/- 11.9 years. The right radial artery was used in 93% of the cases. Either left or right coronary angiography was possible in 94% of the Brachial type K cases, and in 97% of the Judkins Left cases (p = 0.11). Overall, a single-catheter procedure was possible in 87% of the cases (85% with Brachial Type K and 92% with Judkins Left 3.5; p = 0.01). There were no significant differences in fluoroscopy time (4.8 +/- 3.8 minutes versus 5.0 +/- 3.8 minutes; p = 0.61), or in dye volume (103 +/- 33 ml versus 114 +/- 78 ml; p = 0.15). There were no cases of femoral or contralateral arm crossover, and no coronary or aortic dissections or systemic embolization.

CONCLUSION: A strategy of performing both left and right coronary angiography with a single Brachial Type K or Judkins Left catheter by the transradial technique is attractive and appears to be safe and effective.