Routine transradial coronary angiography in unselected patients

OBJECTIVES: To measure and compare the results of changing from routine transfemoral to routine transradial coronary angiography performed by a single operator. DESIGN: A learning period of 3 months for the transradial procedure with 43 selected patients was followed by a 12-month routine period with 243 unselected patients. The success and complication rates, contrast volumes, catheter and X-ray times were measured and compared to results of a preceding period where the transfemoral approach was used. Follow-up was performed in the transradial groups 1.5-25 months after the procedure. RESULTS: Of the non-selected patients, 9% were deemed unsuitable for the radial procedure. In the remaining 91% in which the transradial route was attempted, success was achieved in 91%. The complication rate was 2.7%. Increased operator experience reduces catheter and fluoroscopy times. At follow-up, 4.7% of the radial arteries were occluded, but the patients were without clinical sequelae. The occlusion rate was significantly higher with an unsuccessful procedure. CONCLUSIONS: Transradial coronary angiography can be performed safely and with acceptable image quality in non-selected patients after a learning period of 43 cases. Total procedure time is shorter than with the transfemoral approach. There were no bleeding complications and no procedure-related complications that required treatment.