title: Left Radial Versus Femoral Access for Coronary Angiography in Post-Coronary Artery Bypass Graft Surgery Patients.
abstract: It has been recently demonstrated that coronary angiography of native coronary arteries via the radial artery results in reduced morbidity and mortality, when compared with a femoral approach. However, the efficacy and safety of the transradial approach in patients with coronary grafts is relatively unknown. We performed a retrospective audit of all patients with a history of previous coronary artery bypass graft (CABG) surgery who underwent diagnostic angiography at our institution from 2008-2012. The primary efficacy endpoint was procedure time (minutes), while the secondary efficacy measure was patient radiation exposure (μGy/m²). There were 326 post-CABG patients studied during the defined period, with 254 via femoral approach and 72 via left radial artery. There was no significant difference between the two approaches in procedure time (37 minutes in radial group vs 35 minutes in femoral group; t-test, P=.43). There was also no difference in radiation exposure (7855 μGy/m² in femoral group vs 6825 μGy/m² in radial group; Satterthwaite t-test, P=.08). This study shows the validity of a left radial approach in patients who have undergone angiography post CABG. It suggests that transradial angiography can be safely performed in these patients, without significant increase in procedural time or radiation exposure.
authors.affiliation: Cardiology Department, North Shore Hospital, Shakespeare Road, Takapuna, Auckland, New Zealand. tfjpasley@hotmail.com.
authors.forename: Thomas F
authors.initials: TF
authors.lastname: Pasley
authors.forename: Ali
authors.initials: A
authors.lastname: Khan
authors.forename: Lu-Yin
authors.initials: LY
authors.lastname: Yen
authors.forename: Ruth
authors.initials: R
authors.lastname: Newcombe
authors.forename: Hayley
authors.initials: H
authors.lastname: Humphreys
authors.forename: Seif
authors.initials: S
authors.lastname: El-Jack
mesh_terms: D000368:Aged; D006328:Cardiac Catheterization / Q000379:methods*; D017023:Coronary Angiography / Q000379:methods*; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000601:surgery*; D003331:Coronary Vessels / Q000000981:diagnostic imaging*; D005260:Female; D005263:Femoral Artery; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D011184:Postoperative Period; D017534:Radial Artery; D012189:Retrospective Studies