Feasibility and Problems in Transradial Coronary Angiography and Intervention

Han, Kyoo Rok

Abstract

BACKGROUND AND OBJECTIVES: The transradial coronary angiography and intervention is on the increase with its satisfactory results. It gives advantages of reduced vascular complication and increased comfort of patients. We evaluated the feasibility and problems of transradial coronary angiography and intervention as a routine procedure. MATERIALS AND METHOD: Between February 1998 and December 1999 transradial approach was attempted in 750 patients with normal Allen test. Radial angiography was performed to assess the radial artery spasm and tortuosity. Arterial sheath was removed immediately after the procedure and vascular complications were evaluated before discharge.
RESULTS
Radial artery puncture was successful in 738(98%) patients. Transradial coronary angiography was successful in 719(96%) patients. We failed in coronary angiography in 19 patients and the main reasons were tortuous subclavian artery in 11 patients and radial artery spasm in 5 patients. Transradial coronary angioplasty was performed successfully in 185(95%) of 194 patients. In 9 patients intervention was switched to transfemoral approach because of tortuous subclavian artery. Complications were severe radial artery spasm in 13(1.8%), minor subcutaneous hemorrhage in 7(0.9%), non-ischemic radial artery occlusion in 4(0.5%) and radial artery perforation in 1(0.1%). But, there were no major complications requiring vascular surgery or transfusion.
CONCLUSION
Transradial coronary angiography and intervention might be useful and safe as a routine procedure. The major limitations in transradial approach were radial artery spasm and toruosity of brachial or subclavian artery.