Routine Transradial Coronary Angiography in Unselected Patients
- Volume 17 - Issue 3 - March, 2005
- Posted on: 8/1/08
- 0 Comments
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Transfemoral coronary angiography is not always possible because of obstructive arterial disease, and following the procedure, hemostasis can be difficult to achieve. An alternative transradial procedure described by Campeau1 has been widely accepted both by operators and patients.2 Using 5 or 6 Fr catheters, it has even replaced the transfemoral approach as the routine method in some centers. The benefits of transradial angiography include immediate ambulation and a low risk of bleeding, hematoma, and pseudoaneurysm. However, it is technically more demanding, and thrombotic occlusion of the small radial artery occurs in 1–6% of the patients.2,3 Therefore, an abnormal modified Allen’s test, which indicates insufficient collateral capacity from the ulnar artery, is generally considered a contraindication to the transradial method. Relative contraindications are the need to visualize the contralateral internal mammary artery, and reduced renal function in order to keep the radial artery intact in the event of a subsequent need for a hemodialysis shunt.
We have performed transfemoral coronary angiography at Viborg Hospital since 1998. Patients in whom this approach was not possible had to be referred to Aarhus University Hospital in Skejby for a transbrachial or radial procedure. To avoid this, we decided to begin performing transradial angiography in 2001.
This paper describes the results obtained by a single operator during a learning phase of three months with selected patients, followed by a twelve-month period, with the intention to use the radial artery in all patients undergoing coronary angiography. Follow-up was performed 1.5–25 months after the procedure.