Abstract 8526: Comparison of Transradial Coronary Angiography via Right or Left Radial Artery Approaches in Contemporary Real World Cardiology Practice. A PREVAIL Study data subanalysis
Introduction. Previous studies in small subgroups of patients undergoing transradial catheterization have suggested that the right radial artery approach may encounter more technical difficulties than the left radial approach.
Hypothesis. We performed a subanalysis of the PREVAIL study in order to test the hypothesis that the two approaches are actually different in the contemporary real world practice.
Methods. PREVAIL study was a prospective, observational survey of unselected consecutive patients undergoing invasive cardiovascular procedures at 9 Italian hospitals over a one month observation period specifically aimed at assessing the outcomes of radial approach in contemporary real world. The choice of arterial approach (radial vs femoral, right radial vs left radial) were left to the discretion of the operator. Pre-specified end-points of this subanalysis were the procedural characteristics, expressly defined in the case report form to control for confounders
Results. Of 1,052 patients consecutively enrolled, 509 patients underwent transradial catheterization (304 right radial and 205 left radial approach). The clinical characteristics were similar between the 2 groups. A similar proportion of patients in the 2 groups had coronary angiography only (59% vs 61%) or percutaneous coronary intervention (41% vs 39%), with no difference in urgent cases (37% vs 34%). Also, procedural success rates were similar in the 2 groups (97% vs 96%, respectively). As compared with left radial, the right radial group had longer total duration of the procedure (46+29 vs 33+24 min, P<0.0001) and fluoroscopy time (765+787 vs 533+502 s, P<0.0001). No differences were found in quantity of contrast injected (182+115 vs 176+112 ml) and numbers of catheters used per procedure (2.8+1.1 vs 2.8+1.1). Similar results were obtained when only operators with high (>65%) right radial vs left radial volume were compared.
Conclusions. The right and left radial artery approaches are feasible and effective to perform coronary angiography and intervention. In contemporary real world, however, patients undergoing the left radial route had shorter procedures and lower radiological exposure as compared to those undergoing a right radial approach.
- © 2011 by American Heart Association, Inc.