Feasibility of Transradial Coronary Angiography Using a Single Judkins Left Catheter

Park, Eun Hee; Kim, Moo Hyun; Park, Tae Ho; Ahn, Sang Joon; Jung, Dong Sik; Paik, Jeung Hoan; Cha, Kwang Soo; Kim, Young Dae; Kim, Jong Seong

Abstract

BACKGROUND AND OBJECTIVES
Transradial coronary angiography and intervention are getting more popularity throughout the world because of lower incidence of puncture site complications and the patients have displayed early ambulation. However, radial arterial spasms and possible endothelial injury due to the small size of radial artery are troublesome. To overcome this problem, we investigated the usefulness of performing transradial coronary angiography using a single Judkins left catheter (JL).
SUBJECTS AND METHODS
A total of 268 patients who underwent right transradial coronary angiography from June 2003 to December 2003 were enrolled for this prospective study. The Judkins Left 3.5(JL3.5), the Multipurpose (MP) and Amplatz Left (AL2 for males, AL1 for females) were assigned to be used in patients with a randomized protocol. The technical/angiographic success rate, procedural/fluoroscopic time and the frequency of stiffwire usage were assessed.
RESULTS
Technical success was accomplished in 87 (96.7%) of the patients with a single JL3.5, in 90 (97.8%) of the patients with the MP and in 83 (96.5%) of the patients with the AL catheter. Successful angiography success was achieved in 77 (85.6%) of the patients using the JL3.5, in 71 (77.2%) of the patients using the MP and in 66 patients (76.7%) using the AL. The technical success rate (p=0.270) and the angiographic success rate (p= 0.162) showed no significant difference among the three catheters. The procedural time was 8.1+/-4.0 min in the JL3.5 group, 8.1+/-3.7 min in the MP group and 7.3+/-3.4 min in the AL group, respectively (p=0.431). Also, the fluoroscopic time was not different among the three groups.
CONCLUSION
The JL3.5 catheter is an excellent tool for both coronary imaging and it is equally successful as compared with the MP and AL catheters. Therefore, the JL3.5 may be considered as the initial catheter that can be used, including for those difficult cases having tortuous vasculature of the subclavian artery and the ascending aorta, during transradial coronary angiography.