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Comparison of a single dedicated catheter and the Judkins catheter for coronary angiography using the right transradial access

BACKGROUND: Radial spasm is considered one of the main reasons of failure in the transradial approach. The prolonged procedure time, use of large diameter catheters, catheter frictions during manipulation and number of catheters used are among the main causes of radial spasm. The use of catheters dedicated to radial access could minimize such factors, with a consequent reduction in the incidence of spasm. METHODS: Prospective registry of consecutive patients with suspected coronary artery disease undergoing coronary angiography using the right radial access, with 5 F sheaths. We compared the procedural success, the strategy success, duration of the procedure, fluoroscopy time and the number of catheters used among patients who used the dedicated catheter (OptitorqueTM TIG) with those using the Judkins catheter (JL/JR). RESULTS: From September 2009 to July 2010, 300 patients using the dedicated catheter (group I) were included and compared with a control group with the same number of patients whose procedure was performed using Judkins catheters (group II). There was a higher procedure success rate in group I (100% vs. 98%; P = 0.03) and no difference in the chosen strategy success (93.7% vs. 95%; P = 0.59). There was a statistically significant decrease in the duration of the procedure (13.6 ± 6 min vs. 15 ± 6.4 min; P = 0.007), in fluoroscopy time (2.5 ± 1.6 min vs. 3.1 ± 2.2 min; P = 0.0009) and number of catheters (1.1 ± 0.3 vs. 2.1 ± 0.6 min; P < 0.0001) in group I. There was no difference in the occurrence of spasm (4.7% vs. 5.7%; P > 0.99). CONCLUSIONS: The use of a dedicated radial catheter was effective and safe, with a significant reduction in fluoroscopy time, length of procedure and the total number of catheters used, with a possible reduction in the cost of the procedure, but no reduction in the incidence of spasm or other complications.

Radial artery; Coronary angiography; Catheterization


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