Transradial Approach for Coronary Angiography and Interventions: Practical Applicability at a High-volume Laboratory and Safety in Korean Patients

Cha, Kwang Soo; Kim, Moo Hyun; Kim, Young Dae; Kim, Hye Jin; Son, Young Ki; Park, Seong Wook; Lee, Cheol Jong; Lee, Jong Hoon; Park, Jeong Woon; Kim, Sung Hyun; Kim, Jong Seong

Abstract

BACKGROUND AND OBJECTIVES
Radial approach was introduced as a route for coronary angiography or interventions. We assessed clinical applicability at a high-volume laboratory and safety. MATERIALS AND METHOD: Procedure-related results were compared between phase I period including learning curve and phase II period in 326 patients, in whom coronary angiography or interventions were performed by radial approach.
RESULTS
1) Success rate was 90% (292/326) in all patients, which significantly increased to 95% (246/259) during phase II compared to 69% (46/67) during phase I. 2) Time from local anesthesia to sheath placement and time for first coronary cannulation were 4.3+/-2.7min, 3.1+/-1.9min, respectively, in all patients, which significantly decreased to 3.8+/-3.6min, 2.7+/-2.4min during phase II compared to 7.0+/-3.2min, 5.7+/-4.7min during phase I. Total examination time was 21.7+/-5.5min in all patients, which significantly decreased to 20.4+/-6.2min during phase II compared to 28.3+/-8.0min during phase I. 3) Overall procedural success rate of coronary interventions was 94% (98/104). Guidewire didn't pass in 5 (5%) patients with chronic total occlusion and stent wasn't delivered in 1 (1%) due to poor guiding backup. 4) During follow-up of 61+/-25 days, weak or absent radial pulse, abnormal reverse Allen test were observed in 13 (5%), 3 (1%), 15 (6%) patients, respectively, but no claudication observed.
CONCLUSION
Coronary angiography and interventions by radial approach was safe and performed without more time delay after learning curve.