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...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.展开更多
目的探讨5 F Tiger Ⅰ导管塑形技术在复杂冠状动脉造影中应用的效果。方法本研究为单中心、单盲、随机、平行对照试验，连续入选2016年1月至2017年6月在成都医学院第一附属医院首次冠状动脉造影中采用5 F Tiger Ⅰ导管不能完成显影的研...目的探讨5 F Tiger Ⅰ导管塑形技术在复杂冠状动脉造影中应用的效果。方法本研究为单中心、单盲、随机、平行对照试验，连续入选2016年1月至2017年6月在成都医学院第一附属医院首次冠状动脉造影中采用5 F Tiger Ⅰ导管不能完成显影的研究对象159例。采用随机数字表法，将研究对象分为两组：对照组79例，采用6 F Judkins及Amplatz导管，经桡动脉途径行冠状动脉造影；试验组80例，采用5 F Tiger Ⅰ造影导管塑形技术，经桡动脉途径行冠状动脉造影。将复杂冠状动脉造影原因分为A、B、C 3类：A类为左、右冠状动脉起源异常；B类为左、右冠状动脉开口较常规开口高或低，或开口向下、向上；C类为升主动脉较长、较宽，或较短、较细。比较两组的冠状动脉造影情况及手术并发症。结果试验组在冠状动脉造影中的X线暴露时间[（4.17±1.67）min比（4.78±1.51）min，P=0.017]、X线剂量[230（175, 275）mGy比267（230, 321）mGy, P〈0.001]、对比剂剂量[（54.6±8.2）ml比（61.8±7.9）ml, P=0.001]、手术时间[21.6（18.9, 25.4）min比26.8（23.4, 31.4）min, P〈0.001]和使用的导管数量[（1.30±0.56）根比（2.47±0.57）根, P=0.001]均少于对照组。试验组与对照组的冠状动脉造影成功率差异无统计学意义[97.5%（78/80）比98.7%（78/79）,P=0.567]。试验组与对照组术中发生桡动脉痉挛[2.5%（2/80）比5.1%（4/79），P=0.396]和冠状动脉痉挛[1.3%（1/80）比3.8%（3/79），P=0.639]的比例差异均无统计学意义。在A和C类原因的研究对象中，两组之间的X线暴露时间、X线剂量和手术时间差异均无统计学意义（P均〉0.05），试验组使用的导管数量均少于对照组（P均〈0.01）。在C类原因的研究对象中，试验组使用的对比剂剂量少于对照组（P=0.001）。在B类原因的研究对象中，试验组的X线剂量、对比剂剂量、手术时间和使用的导管数�展开更多
文摘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.
