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Minerva Cardiology and Angiology 2021 Jun 17

DOI: 10.23736/S2724-5683.21.05626-X

Copyright © 2021 EDIZIONI MINERVA MEDICA

language: English

A randomized trial comparing left distal radial versus femoral approach for coronary artery bypass graft angiography: a pilot study

Muhammed N. AKSOY , Salih SAHINKUS, Mustafa T. AGAC, Ersan TATLI

Department of Cardiology, Faculty of Medicine, Sakarya University, Sakarya, Turkey


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BACKGROUND: Left distal transradial angiography (ldTRA) is a new technique for radial coronary angiography and may be an alternative to conventional transfemoral angiography (TFA) in patients who had previously undergone coronary artery bypass graft (CABG) surgery. In this study we compared ldTRA with TFA in patients who had undergone CABG surgery in terms of procedural details.
METHODS: 57 consecutive patients with history of previous CABG among 459 patients who were admitted to coronary angiography unit (elective and acute coronary syndromes) in our center between October 2019 and February 2020 were included in the study. Consecutive patients were randomized to ldTRA (34 patients) and TFA (23 patients) group. The difference in total procedure times was defined as primary endpoint. The difference in sheat times, fluoroscopy times, contrast volume used and radiation exposure were designated as secondary endpoints. Post angiographic complications were compared between two groups.
RESULTS: Out of 34 patients, successful distal radial access was obtained in 25 patients (74%). Baseline demographics, contrast use and radiation exposure were similar between groups. Sheath times in ldTRA was significantly longer (p<0.001), but total procedure times were not different (18.4±7.8 vs. 14.6±6.1, p=0.07). Non-standard angiographic equipment usage was significantly higher in ldTRA procedures (80% vs 13%, p<0.001). There was no major bleeding in neither of groups, and 3 minor bleedings in FA group (0% vs.13%, p=0,10).
CONCLUSIONS: ldTRA in patients with a palpable pulse and successful access might be used successfully for angiography in patient with previous CABG even early in an operator's experience.


KEY WORDS: Snuffbox angiography; CABG angiography; Femoral angiography

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