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KMID : 0368120090390080304
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Korean Circulation Journal
2009 Volume.39 No. 8 p.304 ~ p.309
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The Feasibility of Bypass Graft Angiography by Right Radial Access
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Lee Jae-Hoon
Park Tae-Ho
Cha Kwang-Soo
Kim Moo-Hyun
Kim Young-Dae
Kum Dong-Sung
Lee Sang-Yeob
Choi Jae-Hyuk
Kim Min-Ji
Chung Suk-Hwan
Park Jong-Sung
Nam Young-Hee
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Abstract
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Background and Objectives : Left transradial coronary angiography may result in damage of both radial arteries in patients who experienced right radial access. In some patients, the left radial artery has been used as a graft. We investigated whether graft angiography using right radial access is feasible in patients with bypass surgery to preserve the left radial artery as a future graft.
Subjects and Methods : A total of 109 consecutive patients with bypass surgery who had undergone right radial access underwent graft angiography via the same access.
Results: Sixteen (15%) patients were excluded because of the presence of a severely tortuous right subclavian artery. Bypass graft angiography via right radial or brachial access was completed successfully in 90 (97%) out of 93 patients. In 3 (3%) of patients, femoral access was needed to complete the angiography. Saphenous vein grafts were cannulated selectively in 150 (90%) of 167 grafts with satisfactory image quality and not found even on the aortogram in the other 17 (10%) grafts. Ninety-two (89%) out of 103 left mammary grafts were cannulated selectively or semi-selectively using a modified Simmons catheter, resulting in satisfactory image quality. The other 11 (11%) grafts were visualized non-selectively using a Judkins Left catheter, and resulting in acceptable image quality in 10 (91%) grafts. There were no procedure-related complications.
Conclusion: Graft angiography via right radial access can be performed reliably in most patients that lack severe subclavian tortuosity.
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KEYWORD
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Coronary artery bypass, Angiography, Radial artery, Mammary arteries, Saphenous vein
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