title: Arterial anatomic variations and its influence on transradial coronary procedural outcome.
abstract: OBJECTIVE
  Our aim was to establish the frequency of arterial anatomic variations and its relation to coronary procedural outcome in patients undergoing a first transradial coronary procedure.
  
  
  METHODS
  This was a single center prospective study. A total of 1,446 consecutive patients undergoing their first transradial coronary procedure were recruited. Retrograde radial arteriography was performed to define radial artery anatomy. If the operator encountered serious problems during crossing the subclavian-aortic truncus, retrograde subclavian arteriography was also performed. Patient demographics; procedural data such as: total procedural duration, the number of catheters and guidewires used, the amount of contrast media usage, dose area product (DAP), and fluoroscopy time; and vascular complications were recorded.
  
  
  RESULTS
  Anatomic variations were noted in 270 patients (18.6%), and these patients were significantly older (mean age 64.4 ± 10.4 vs. 59.2 ± 10.8 years, P < 0.001) and more commonly female (46% vs. 33%, P < 0.001) with significantly higher procedural failure rates (8.8% vs. 5.6%, P = 0.006). In addition, procedural duration (P < 0.001) and fluoroscopy time (P < 0.001) were statistically longer in patients with anatomic variations. Anatomic variations also had an adverse impact on the amount of contrast agent usage (63.9 ± 28.3 mL vs. 59.1 ± 25.3 mL, P = 0.006) and minor vascular complication rate (P = 0.007).
  
  
  CONCLUSIONS
  This study indicates that anatomic variation of the arterial path has an adverse impact on transradial coronary procedural outcome.
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; D000792:Angiography; D015906:Angioplasty, Balloon, Coronary; D006328:Cardiac Catheterization / Q000379:methods*; D017023:Coronary Angiography / Q000379:methods*; D003324:Coronary Artery Disease / Q000628:therapy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017534:Radial Artery / Q000000981:diagnostic imaging / Q000473:pathology*; D016896:Treatment Outcome