Transradial approach for coronary angiography and interventions: results of the first international transradial practice survey.
OBJECTIVE
The aim of this study was to evaluate practice of transradial approach (TRA).


BACKGROUND
TRA has been adopted as an alternative access site for coronary procedures.


METHODS
A questionnaire was distributed worldwide with Internet-based software.


RESULTS
The survey was conducted from August 2009 to January 2010 among 1,107 interventional cardiologists in 75 countries. Although pre-TRA dual hand circulation testing is not uniform in the world, >85% in the U.S. perform Allen or oximetry testing. Right radial artery is used in almost 90%. Judkins catheters are the most popular for left coronary artery angiographies (66.5%) and right coronary artery angiographies (58.8%). For percutaneous coronary intervention (PCI), 6-F is now standard. For PCI of left coronary artery, operators use standard extra back-up guiding catheters in >65% and, for right coronary artery 70.4% use right Judkins catheters. Although heparin remains the routine antithrombotic agent in the world, bivalirudin is frequently used in the U.S. for PCI. The incidence of radial artery occlusion before hospital discharge is not assessed in >50%. Overall, approximately 50% responded that their TRA practice will increase in the future (68.4% in the U.S.).


CONCLUSIONS
TRA is already widely used across the world. Diagnostic and guiding-catheters used for TRA remain similar to those used for traditional femoral approach, suggesting that specialized radial catheters are not frequently used. However, there is substantial variation in practice as it relates to specific aspects of TRA, suggesting that more data are needed to determine the optimal strategy to facilitate TRA and optimize radial artery patency after catheterization.
Quebec Heart-Lung Institute, Quebec, Canada. Olivier.bertrand@crhl.ulaval.ca
Olivier F
OF
Bertrand
Sunil V
SV
Rao
Samir
S
Pancholy
Sanjit S
SS
Jolly
Josep
J
Rodés-Cabau
Eric
E
Larose
Olivier
O
Costerousse
Martial
M
Hamon
Tift
T
Mann
D000328:Adult; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D001157:Arterial Occlusive Diseases / Q000453:epidemiology / Q000209:etiology; D057785:Catheters; D017023:Coronary Angiography / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D005260:Female; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D019538:Health Care Surveys; D006489:Hemostatic Techniques; D006801:Humans; D015994:Incidence; D020407:Internet; D008297:Male; D008875:Middle Aged; D010351:Patient Discharge; D018579:Patient Selection; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D017534:Radial Artery; D018570:Risk Assessment; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome
D005343:Fibrinolytic Agents