title: A randomized study comparing the effectiveness of right and left radial approach for coronary angiography.
abstract: OBJECTIVE
  Our aim was to compare the effectiveness between right radial approach (RRA) and left radial approach (LRA) by means of a randomized study in a large unselected patient population undergoing diagnostic coronary angiography.
  
  
  METHODS
  Totally, 1,000 patients were randomized to undergo to RRA (n = 500) or LRA (n = 500). Procedure success was defined as coronary angiography completed with the initial radial artery approach without changing to another route. Performance of the procedure: Total procedural duration, the number of catheters and guidewires used were recorded. Safety of the procedure: The parameters collected for radiation exposure were dose area product (DAP) and fluoroscopy time.
  
  
  RESULTS
  The percentage of success was not different between the two aproaches (LRA, 94.0%; RRA,93.8%; P = 0.96). The crossover rate to femoral was low, accounting for 38 cases (3.8%), without differences between RRA and LRA (20 and 18 cases, respectively, P > 0.05). An almost triple incidence of operator-reported subclavian tortuosity in the RRA compared with LRA was observed (44 cases vs. 15 cases, P < 0.001). With respect to the total procedural duration there was no difference between those two aproaches (LRA, 8.54 ± 4.09 min vs. RRA, 8.63 ± 5.20; P = 0.772). However, the fluoroscopy time was significantly shorter via the LRA compared with RRA (2.76 ± 2.00 min vs. 3.08 ± 2.62 min; P = 0.029).
  
  
  CONCLUSIONS
  LRA for coronary angiography is associated with the same success rate and procedural duration time compared with RRA. However, the fluoroscopy time is significantly shorter in favor of LRA.
authors.affiliation: Cardiology Department, Acibadem University, Istanbul, Turkey.
authors.forename: Tugrul
authors.initials: T
authors.lastname: Norgaz
authors.forename: Sevket
authors.initials: S
authors.lastname: Gorgulu
authors.forename: Sinan
authors.initials: S
authors.lastname: Dagdelen
mesh_terms: D000368:Aged; D062906:Cardiac Catheters; D016009:Chi-Square Distribution; D017023:Coronary Angiography / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D061214:Patient Safety; D011237:Predictive Value of Tests; D011446:Prospective Studies; D017534:Radial Artery; D011829:Radiation Dosage; D018570:Risk Assessment; D012307:Risk Factors; D013997:Time Factors; D014421:Turkey