Coronary angiography using the left distal radial approach - An alternative site to conventional radial coronary angiography

Özet

Objective: To share our experience with the left distal radial approach for transradial coronary angiography and interventions. By performing theradial puncture in the fossa radialis or the so called anatomical “Snuffbox” we aimed to present the feasibility and complications of this newtechnique.Methods: Left distal radial artery was used as an access site in 54 patients admitted to our clinic for coronary angiography and intervention betweenMay 25th and October 20th 2017. All of them had pulse in their left distal radial artery. In the laboratory, they had their left arm gently flexedat the shoulder so that the hand was placed over their right groin. The operator stood on the right side of the patient and performed coronaryangiography and interventions. During the hospital stay, demographic features and complications were recorded.Results: Mean age of patients was 59.3 years and 80% were male. We used Judkins 6 French catheters for the procedures. Seventeen patientsadmitted with acute coronary syndrome. They all underwent successful left distal transradial coronary angiography and intervention. Primaryangioplasty was performed in 10 patients. In total, 20 patients had coronary intervention. Left anterior descending artery was the artery requiringmost intervention (11 patients). Two patients experienced brachial spasm requiring crossover to right femoral artery. There were no casesof radial artery occlusion, hematoma, or hand numbness. The radial sheath was removed at procedure termination. Hemostasis was achievedwith manual compression.Conclusion: Left distal radial approach is safe and feasible as a new technique for coronary angiography and interventions.