title: Effectiveness of Handmade "Jacky-Like Catheter" As a Single Multipurpose Catheter in Transradial Coronary Angiography: A Randomized Comparison With Conventional Two-Catheter Strategy.
abstract: OBJECTIVE
  To investigate safety and efficacy of specialized hand-modified "Jacky-Like" catheter (JLC) as a single dual-purpose catheter in transradial coronary angiography.
  
  
  METHODS
  Patients over 18 years undergoing diagnostic CAG through right radial artery (RRA) were prospectively enrolled. Procedures were performed with a single JLC modified from a left Judkins (JL) 3.5 catheter or by using 2-catheter approach (2C). Procedures with coronary artery bypass grafts or ventricular angiographies were excluded from the study. Three hundred and eighty-seven transradial procedures were performed successfully. One hundred and ninety-four procedures were performed with 2C and 193 procedures with a JLC. Inability to use intended catheters, total fluoroscopic time in minutes, the consumption of contrast medium in milliliter, development of radial artery spasm (RAS), and radial artery occlusion (RAO) were evaluated.
  
  
  RESULTS
  In the 2C group, angiography was successfully performed on the RCA of 191 patients (98.9%) and on LCA in 192 patients (99.4%). In the JLC group, angiography was successfully performed on the RCA and LCA of 193 (99.4%) and 174 (89.6%) patients, respectively. Utilization of supplemental catheters was significantly greater in the JLC group (21; 10.8%) versus the 2C group (3; 1.5% P = 0.001). Mean fluoroscopy time was shorter in the JLC group (2.0 ± 2.3 min vs. 2.3 ± 1.5 min; P = 0.043). Mean procedure time was also decreased with JLC but did not reach statistical significance (5.7 ± 3.1 min vs. 6.2 ± 2.5 min; P = 0.081). When additional time for reshaping the JLC was not taken into account, mean procedure time was significantly decreased in the JLC group (5.6 ± 2.9 min vs. 6.2 ± 2.4 min; P = 0.031). There was a trend toward lower incidence of consumption of contrast medium in the 2C group (49 ± 13 mL vs. 52 ± 18 mL; P = 0.061). RAS was observed more frequently in the 2C group (11.3% vs. 21.7%, P = 0.005). There was a trend toward high incidence of RAO in the 2C group (4.1 vs. 8.3% P = 0.064).
  
  
  CONCLUSIONS
  In transradial procedures from RRA, a JLC catheter can be very effective when dedicated dual-purpose catheter is not available.
authors.affiliation: Department of Cardiology, VM Medicalpark Kocaeli Hospital, Kocaeli, Turkey.
authors.forename: Ismail
authors.initials: I
authors.lastname: Erden
authors.affiliation: Department of Cardiology, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey.
authors.forename: Ebru
authors.initials: E
authors.lastname: Golcuk
authors.affiliation: Department of Cardiology, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey.
authors.forename: Serdar
authors.initials: S
authors.lastname: Bozyel
authors.affiliation: Department of Cardiology, VM Medicalpark Kocaeli Hospital, Kocaeli, Turkey.
authors.forename: Emine Cakcak
authors.initials: EC
authors.lastname: Erden
authors.affiliation: Department of Cardiology, VM Medicalpark Kocaeli Hospital, Kocaeli, Turkey.
authors.forename: Yakup
authors.initials: Y
authors.lastname: Balaban
authors.affiliation: Department of Cardiology, Bayrampaşa Kolan Hospital, Istanbul, Turkey.
authors.forename: Kivanc
authors.initials: K
authors.lastname: Yalın
authors.affiliation: Department of Cardiology, Kocaeli Derince Training and Research Hospital, Kocaeli, Turkey.
authors.forename: Burak
authors.initials: B
authors.lastname: Turan
mesh_terms: D000368:Aged; D062906:Cardiac Catheters; D003287:Contrast Media; D017023:Coronary Angiography / Q000295:instrumentation*; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging*; D004867:Equipment Design; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D017534:Radial Artery
chemical_list: D003287:Contrast Media