Objective
Although transradial procedures can be performed more effectively with specially designed catheters, most of interventional cardiologists around the world still use standard femoral catheters, mainly due to familiarity and high availability, instead of special transradial catheters. The aim of this study was to investigate the safety and efficacy of left Judkins catheter as a single multipurpose catheter in transradial coronary angiography.
Methods
Patients undergoing transradial angiography through right radial artery were randomized into single-catheter approach with left Judkins 3.5 and two-catheter approach with left Judkins 3.5 and right Judkins 4.0 catheters. Primary outcome measures were the rate of success in selective and stable engagement of both coronary arteries with left Judkins catheter, procedure and fluoroscopy times.
Methods
Patients undergoing transradial angiography through right radial artery were randomized into single-catheter approach with left Judkins 3.5 and two-catheter approach with left Judkins 3.5 and right Judkins 4.0 catheters. Primary outcome measures were the rate of success in selective and stable engagement of both coronary arteries with left Judkins catheter, procedure and fluoroscopy times.
Results
Of 314 patients enrolled (Figure 1), 206 patients (aged 60.3±12.4 years, 36.9% female) were randomized. Baseline characteristics of two groups were well balanced and there was no significant difference between two groups with regard to number of recorded angiographic images, contrast volume, severity of coronary artery disease and advised treatment (Table 1). Left Judkins was successful in 66.0% of patients as a single catheter. Additional catheter was needed more frequently in single-catheter group (34 versus.97%, p<.001). Single-catheter approach reduced procedure time significantly (6.7 ± 2.1 versus 7.9 ± 3.3 minutes, p=.002). However on average there was 19.7% relative increase in fluoroscopy time (2.61 ± 1.38 versus 2.18 ± 1.54 minutes, p=.035) with single-catheter approach. Radial artery spasm tended to develop more frequently in two-catheter group (22.3 versus 12.6%, p=.067). In nearly half of the patients, procedure had been completed successfully with left Judkins catheter within a fluoroscopy time similar to that of two-catheter group. Left Judkins catheter seemed to be less successful in cannulating right coronary arteries arising above sinotubular junction and/or with a downward angulation.
Stay updated, free articles. Join our Telegram channel
Full access? Get Clinical Tree
