INTRODUCTION AND OBJECTIVES: The right radial (RR) approach has been incorporated into daily clinical practice as a valid alternative to the femoral (F) approach. The left radial (LR) approach is seldom used and few data are available from randomized studies comparing this approach with F and RR approaches. METHODS: We randomized 1005 consecutive patients referred to a tertiary-care hospital for cardiac catheterization to different approaches. Procedures were performed by three interventional cardiologists experienced in transradial catheterization. There were no exclusion criteria. The primary end-point was the percentage of procedures completed using the assigned approach. Secondary endpoints were the percentage completed in the absence of contraindications to any approach, the duration of the procedure, and the incidence of vascular complications. RESULTS: More procedures were completed with the F approach (LR, 71%; F, 92%; RR, 68%; P< .001). The success rate in the absence of contraindications to any approach (n=907) was greater with the F approach, with no difference between LR and RR approaches (LR, 80%; F, 96%; RR, 82%; P< .001). The canalization time was greater with the LR approach (P< .001), the time required for diagnosis was shorter with the F approach (P< .001) and compression was faster with the radial approach (P< .001). There was no difference in the total duration of diagnostic procedures (P=.22) or interventions (P=.9). The incidence of vascular complications was lower with the radial approach (P=.03). CONCLUSIONS: The left radial approach is as valid an alternative to the femoral approach as the right radial approach.
RCT Entities:
INTRODUCTION AND OBJECTIVES: The right radial (RR) approach has been incorporated into daily clinical practice as a valid alternative to the femoral (F) approach. The left radial (LR) approach is seldom used and few data are available from randomized studies comparing this approach with F and RR approaches. METHODS: We randomized 1005 consecutive patients referred to a tertiary-care hospital for cardiac catheterization to different approaches. Procedures were performed by three interventional cardiologists experienced in transradial catheterization. There were no exclusion criteria. The primary end-point was the percentage of procedures completed using the assigned approach. Secondary endpoints were the percentage completed in the absence of contraindications to any approach, the duration of the procedure, and the incidence of vascular complications. RESULTS: More procedures were completed with the F approach (LR, 71%; F, 92%; RR, 68%; P< .001). The success rate in the absence of contraindications to any approach (n=907) was greater with the F approach, with no difference between LR and RR approaches (LR, 80%; F, 96%; RR, 82%; P< .001). The canalization time was greater with the LR approach (P< .001), the time required for diagnosis was shorter with the F approach (P< .001) and compression was faster with the radial approach (P< .001). There was no difference in the total duration of diagnostic procedures (P=.22) or interventions (P=.9). The incidence of vascular complications was lower with the radial approach (P=.03). CONCLUSIONS: The left radial approach is as valid an alternative to the femoral approach as the right radial approach.
Authors: Matthew D Mitchell; Jaekyoung A Hong; Bruce Y Lee; Craig A Umscheid; Sarah M Bartsch; Creighton W Don Journal: Circ Cardiovasc Qual Outcomes Date: 2012-06-26
Authors: Ahmed A Kolkailah; Rabah S Alreshq; Ahmed M Muhammed; Mohamed E Zahran; Marwah Anas El-Wegoud; Ashraf F Nabhan Journal: Cochrane Database Syst Rev Date: 2018-04-18
Authors: Thomas A Meijers; Adel Aminian; Koen Teeuwen; Marleen van Wely; Thomas Schmitz; Maurits T Dirksen; Rene J van der Schaaf; Juan F Iglesias; Pierfrancesco Agostoni; Joseph Dens; Paul Knaapen; Sudhir Rathore; Jan Paul Ottervanger; Jan-Henk E Dambrink; Vincent Roolvink; A T Marcel Gosselink; Renicus S Hermanides; Niels van Royen; Maarten A H van Leeuwen Journal: BMJ Open Date: 2020-07-20 Impact factor: 2.692