The purpose of this study is to show that the radiation exposure of the left distal radial artery approach is superior to the conventional right radial artery approach in terms of less radiation exposure.
The conventional radial approach is now recognized as the basic technique in coronary artery surgery. Compared to the femoral artery access, the main advantage is the increased stability due to the reduction of massive bleeding. Due to these advantages, recent guidelines recommend the conventional radial approach as the basic approach for all acute myocardial infarction (AMI) cases with or without ST-segment elevation. In particular, in the case of ST-segment elevation myocardial infarction (STEMI), new antiplatelet agents such as Ticagrelor and Prasugrel and strong antiplatelet agents such as Glycoprotein inhibitors have been used to prevent major vascular complications. For these many operators, primary percutaneous coronary intervention (PCI) through the radial artery is recommended. At this time, the operator prefers the right radial artery approach because of the comfort of performing the procedure on the patient's right side. However, the operator sometimes has to substitute the left radial artery or femoral artery access due to difficulty in manipulating the catheter due to severe tortuousness of the right subclavian artery. Although the left radial artery approach requires less operation time and radiographic imaging time due to less tortuousness of the left subclavian artery, the right conventional radial approach is still preferred due to the ergonomic inconvenience of having to lean toward the patient. Patients undergoing coronary angiography (CAG) were randomly assigned to the left snuffbox approach and the right conventional radial approach, and the surgeons' radiation exposure between the two approaches was evaluated and compared.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
OTHER
Masking
NONE
Enrollment
1,010
Radial Artery Puncture Method for Coronary Angiography and Intervention
Wonju Severance Christian Hospital
Wŏnju, Gangwon-do, South Korea
Chung-Ang University Gwangmyeong Hospital
Gwangmyeong, Gyeonggi-do, South Korea
Yongin Severance Hospital
Yongin, Gyeonggi-do, South Korea
Radiation exposure examination
Radiation exposure for surgeons in the case of the left distal radial artery approach and the right radial artery approach, respectively
Time frame: Through procedure completion, up to 24 hours
Fluoroscopy time
Fluoroscopy time
Time frame: Through procedure completion, up to 24 hours
Corrected by X-ray dose Radiation exposure of surgeons
Corrected by X-ray dose Radiation exposure of surgeons
Time frame: Through procedure completion, up to 24 hours
Corrected by X-ray dose Radiation
Corrected by X-ray dose Radiation
Time frame: Through procedure completion, up to 24 hours
Hemostasis time
Hemostasis time
Time frame: Through procedure completion, up to 24 hours
Procedure success rate
Procedure success rate
Time frame: Through procedure completion, up to 24 hours
Amount of contrast agent used
Amount of contrast agent used
Time frame: Through procedure completion, up to 24 hours
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