Transradial coronary intervention: Comparison of the left and right radial artery approach

Background and Objectives: We evaluated the efficacy and safety of the left transradial approach as compared to the right radial approach when performing transradial coronary intervention. Subjects and Methods: We performed the transradial coronary intervention in 711 cases via the left approach (Lt. group) and in 614 cases via the right approach (Rt. group) for patients with a normal Allen's test of both arms. We evaluated the procedural success rate, the crossover rate, the puncture time, the total procedural duration, the fluoros copy time, the amount of contrast agent used and the local vascular complications of both groups. Results: The baseline clinical and angiographic profiles were comparable between both groups. The puncture time, the amount of contrast agent used, choice of the guide catheter and local vascular complications were similar for the two groups. There was no difference in the procedural success rate (Rt. group; 96.4% vs. Lt. group; 96.2%, p=NS). However, there was tendency for a higher success rate via radial access for the Lt. group than for the Rt. group (Rt. group; 91.9% vs. Lt. group; 93.5%, p=0.056). The crossover rate was lower for the Lt. group than for the Rt. group (2.7 % vs. 4.6%, respectively; p=0.04). The total procedural time (32.3±15.4. vs. 30.7±17.6 min, respectively; p=0.03) and fluoroscopy time (16.9±12.6 vs. 13.9±7.9 min, respectively; p<0.01) were shorter in the Lt. group. The number of guide catheters used was higher in the Rt. group compared to the Lt. group (1.21±0.48 vs. 1.08±0.33, respectively; p=0.04). Conclusion: The left radial approach may provide increased procedural efficacy for transradial PCI compared to the right radial approach along with similar complications.