Experience with transradial approach in roentgenoendovascular interventions on coronary arteries

Khachaturov A.A.², Khovalkin R.G.¹, Tsygankov V.N.¹, Goncharov A.I.¹, Varava A.B.¹

1) A.V. Vishnevsky Institute of Surgery under the RF Ministry of Public Health
2) Municipal Clinical Hospital No 20, Moscow, Russia

Objective. To assess efficacy of the transradial approach and to evaluate possibility of its wide application for coronary interventions as an alternative to the transfemoral access.

Materials and methods. A total of 317 percutaneous coronary interventions were performed in 312 patients presenting with coronary artery disease.

Percutaneous coronary interventions (PCI) performed through the radial artery (RA) were made using the instruments manufactured by the Terumo Corporation.

Results. The right-sided radial approach (RA) was used to perform 172 (54.25%) diagnostic and 42 (13.25%) therapeutic coronary interventions. In 18.30% (n=58) of cases we failed to perform PCI through the RA due to various reasons. Compression haemostasis on the right radial artery in 100% of cases was performed using the device for compression of the puncture site TR Band (Terumo, Japan). Complications related to the approach occurred in 1.25% of cases: thrombosis of the radial artery with no evidence of ischaemia of the hand (n=1), haematoma of soft tissues of the forearm (n=1), haematoma of soft tissues of the shoulder (n=2).

A dramatic decrease in the duration of PCI was achieved at the expense of using the RA, hydrophilic guide wire and introducer, universal catheter Tiger and Ikari guide catheters (Terumo, Japan).

Conclusions. The radial approach makes it possible to perform coronary interventions rapidly, conveniently for both the patient and the roentgenosurgeon. The use of specialized tools makes it possible to perform an atraumatic and mild arterial access, decreasing the rate of haemorrhagic complications, providing rapidity, safety, and full control over PCI.

KEY WORDS: radial approach, coronarography, device for haemostasis.

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