Objectives: We aimed to evaluate feasibility, contrast utilization and complications of trans-radial approach comparing the left distal trans-radial artery (lt. dTRA) access in the anatomical snuffbox versus conventional right trans-radial artery (rt. TRA) access in coronary angiography procedures.
Subjects and Methods: This study was conducted on one hundred (100) patients who underwent coronary angiography (50 patients via left distal trans-radial approach & 50 patients via conventional right trans-radial approach) and was performed in the department of cardiology, Benha University Hospital, Benha City, Egypt. All patients performed ECG, echocardiography, arterial doppler pre and post procedures.
Results: In comparison with conventional right trans-radial artery (rt. TRA), Our study revealed that performing coronary angiography via lt. dTRA had more difficulties at which it had significantly more failure rate to get puncture (14% in lt. dTRA group and 2% in rt. TRA group, P = 0.03) and high significantly more time to insert a sheath (5.08±0.75 minutes in lt. dTRA group and 4.02±0.55 minutes in rt. TRA group, P˂0.001) but with significantly less contrast volume required (56.50±8.93 ml in lt. dTRA group and 63.20±11.68 ml in rt. TRA group, P=0.002). Also, lt. dTRA approach had significantly less incidence to cause radial artery occlusion (RAO) (8% in lt. dTRA group and 20% in rt. TRA group, P=0.040) and less incidence to cause bleeding (6% in lt. dTRA group and 8% in rt. TRA group, P=0.500) without significant difference but with more incidence to cause infection (4% in lt. dTRA group and 2% in rt. TRA group, P=0.558) without significant difference. Patients were more satisfied when procedures performed via lt. dTRA approach (92% in lt. dTRA group and 80% in rt. TRA group, P=0.084) (non-significant deference) and they had less hospital stay time (3.92±1.06 hours in lt. dTRA group and 5.56±0.951 hours in rt. TRA group, P˂0.001) (highly significant deference).
Conclusion: Compared to conventional right trans-radial artery (rt. TRA) access for coronary angiography procedure, left distal trans-radial artery (lt. dTRA) access has more failure rate to get puncture and more time to insert sheath but with less contrast volume required, less incidence of RAO and less hospital stay time.
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