title: Safety and feasibility of selective angiography of left internal mammary artery grafts via right transradial approach.
abstract: OBJECTIVE
  Right transradial approach (TRA) for cardiovascular procedures is becoming common practice, but angiography and PCI of left mammary artery by-pass graft (LIMA) via the right radial artery is still technically challenging. Aim of the study was to evaluate the possibility to put a stable catheter in left mammary from right radial approach.
  
  
  METHODS
  From June 2002 to March 2009, 246 consecutive patients (88% male; age 67.7 +/- 7.8 years) with previous CABG underwent LIMA graft angiography via right TRA by a single experienced operator.
  
  
  RESULTS
  An adequate radial access was obtained in all patients. Selective angiography of LIMA was successfully performed in 218 patients (89.1%). In the remaining 28 (10.9%) the LIMA approach from right radial failed because of severe tortuosity of brachiocephalic trunk or severe calcified and tortuous left subclavian artery. 13 patients underwent PCI and stentingon mid-distal native LAD trough LIMA using 6FIM4 guiding catheter. No periprocedural cerebro-vascular complications, no vascular injury at the LIMA takeoff as a result of selective canulation, no injury of the left subclavian artery were observed
  
  
  CONCLUSIONS
  In patients with previous CABG, the presence of LIMA grafts is not a limitation to successfully perform diagnostic and interventional procedures via the right radial approach with experienced operators.
authors.affiliation: Interventional Cath. Lab., Cardiovascular Department, Ospedali Riuniti Bergamo, Italy. ovalsec@tin.it
authors.forename: Orazio
authors.initials: O
authors.lastname: Valsecchi
authors.forename: Angelina
authors.initials: A
authors.lastname: Vassileva
mesh_terms: D000368:Aged; D000792:Angiography / Q000379:methods*; D006328:Cardiac Catheterization / Q000379:methods*; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000000981:diagnostic imaging* / Q000601:surgery*; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D007387:Internal Mammary-Coronary Artery Anastomosis; D008297:Male; D008323:Mammary Arteries / Q000000981:diagnostic imaging* / Q000601:surgery*; D017534:Radial Artery / Q000000981:diagnostic imaging*; D013348:Subclavian Artery / Q000000981:diagnostic imaging; D016896:Treatment Outcome