Sa. Joseph et al., A PROSPECTIVE RANDOMIZED TRIAL OF NOVOSTE RIGHT VERSUS JUDKINS CATHETERS FOR ENGAGEMENT OF THE RIGHT CORONARY-ARTERY DURING DIAGNOSTIC CATHETERIZATION, Journal of interventional cardiology, 6(3), 1993, pp. 213-218
There has been little technical advancement in catheter shape for diag
nostic cardiac catheterization since the early reports of Sones and co
lleagues during the development of the procedure. In order to determin
e the utility of a new catheter that directly, without torque or rotat
ion, engages the right coronary artery (RCA), one hundred patients wer
e randomized between 6Fr standard RCA Judkins (6Fr R4) (Cordis Corpora
tion, Miami, FL, USA) or 6Fr Novoste RCA catheters (Novoste Corporatio
n, Aguadilla, Puerto Rico). Endpoints included the duration of the var
ious aspects of the procedure and a qualitative and quantitative asses
sment of angiographic quality. The Novoste RCA catheters were associat
ed with statistically decreased times of catheter insertion (42 +/- 37
vs 90 +/- 119 secs), and engagement (31 +/- 35 vs 77 +/- 117 secs), o
f the right coronary artery as compared to Judkins catheters. Judkins
RCA catheters had a significantly higher primary success rate (96%) th
an the Novoste group (84%, P = 0.045). There was no difference in angi
ographic quality in either group and no complications occurred during
the study. While taller patients (mean 68 in) had increased success wi
th the Novoste catheter, no other clinical, demographic, or anatomical
characteristics of the RCA orifice predicted successful engagement an
d angiography. The direct engagement Novoste RCA catheter is associate
d with a more expeditious procedure than Judkins catheters when they c
an engage the RCA orifice. However, Novoste catheters were less succes
sful and required more frequent exchanges to complete the procedure.