To determine the safety and success of transradial coronary angiography and angioplasty — A local experience

Objective: To determine the safety and success of transradial coronary angiography and angioplasty in a Pakistani population. Methods: This was a prospective study on 264 consecutive patients undergoing transradial coronary angiography (TRCAG) and angioplasty (TRCAP) at Tabba Heart Institute, Karachi between November to December 2008. All patients enrolled in the study underwent Allen s test to ensure dual arterial supply to the hand. Modified Allen s test was performed only when Allen s test was abnormal. Patients were excluded from the study if they had abnormal Allen s and modified Allen s test, were on haemodialysis or had abnormal serum creatinine level. The main outcome measures were success rate and complications of TRAG and TRCAP. Results: The mean age was 57 ±11.08 years with 199 (75.4%) males and 64 (24.6%) females. A total of 182 (76.3%) coronary angiographies and 82 (76.8%) coronary angioplasties were preformed from the trans-radial route in the study period. Overall procedural success rate was 94% for TRCAG with mean procedure time of 23.74 ± 6.26 minutes and mean fluoroscopy time of 5.65 ± 2.3 minutes. The success rate for TRCAP was 93.6% with mean procedure time of 62 ±10.6 minutes and mean fluoroscopy time of 15.78 ± 8.90 minutes. Only 1 patient had mild forearm haematoma and asymptomatic radial artery occlusion occurred in 4 (1.5%) study patients. Conclusion: Trans-radial artery cannulation is a safe and successful route for performance of coronary procedures. It can be used as an acceptable alternate to transfemoral approach.