CORONARY ANGIOGRAPHY FROM THE RADIAL ARTERY - EXPERIENCE, COMPLICATIONS AND LIMITATIONS

Aims: to assess the outcomes, complications and limitations of coronar y angiography performed via percutaneous radial artery puncture. Metho ds and results: two hundred and fifty patients underwent diagnostic co ronary angiography from the radial artery, 182 (72.8%) of whom had con traindications to the femoral approach, for example due to peripheral vascular disease (n=85), therapeutic anticoagulation (29), or failed f emoral approach (17). Procedural success in this high-risk population was achieved in 231 patients (92.4%). Principle reasons for failure we re unsuccessful radial access (5) and arterial spasm (5). Procedure du ration (SD) for an operator's first 20 cases compared with cases there after (min) was 47.7 (16.7) vs. 41.5 (14.6), P=0.0004; fluoroscopy tim e (min) 9.7 (7.1) vs. 6.6 (5.1), P=0.0001 and procedural success 89.6% vs. 94.1%, P=ns. Complications included two deaths associated tempora lly with catheterisation, three cases of arterial dissection without i schaemic sequelae and one transient ischaemic attack. Conclusions: cor onary angiography can be performed successfully from the radial artery , but this approach has limitations, which include the need to demonst rate dual palmar vascular supply, the prolonged learning phase, the pr ocedural failure rate, patient discomfort and a demonstrable incidence of vascular and haemodynamic complications. We believe that radial co ronary angiography should only be undertaken when there is a contraind ication to the femoral approach. (C) 1998 Elsevier Science Ireland Ltd .