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Catheter Cardiovasc Interv. 2012 Aug 1;80(2):260-4. doi: 10.1002/ccd.23463. Epub 2012 Feb 14.

A randomized study comparing the effectiveness of right and left radial approach for coronary angiography.

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Cardiology Department, Acibadem University, Istanbul, Turkey.



Our aim was to compare the effectiveness between right radial approach (RRA) and left radial approach (LRA) by means of a randomized study in a large unselected patient population undergoing diagnostic coronary angiography.


Totally, 1,000 patients were randomized to undergo to RRA (n = 500) or LRA (n = 500). Procedure success was defined as coronary angiography completed with the initial radial artery approach without changing to another route. Performance of the procedure: Total procedural duration, the number of catheters and guidewires used were recorded. Safety of the procedure: The parameters collected for radiation exposure were dose area product (DAP) and fluoroscopy time.


The percentage of success was not different between the two aproaches (LRA, 94.0%; RRA,93.8%; P = 0.96). The crossover rate to femoral was low, accounting for 38 cases (3.8%), without differences between RRA and LRA (20 and 18 cases, respectively, P > 0.05). An almost triple incidence of operator-reported subclavian tortuosity in the RRA compared with LRA was observed (44 cases vs. 15 cases, P < 0.001). With respect to the total procedural duration there was no difference between those two aproaches (LRA, 8.54 ± 4.09 min vs. RRA, 8.63 ± 5.20; P = 0.772). However, the fluoroscopy time was significantly shorter via the LRA compared with RRA (2.76 ± 2.00 min vs. 3.08 ± 2.62 min; P = 0.029).


LRA for coronary angiography is associated with the same success rate and procedural duration time compared with RRA. However, the fluoroscopy time is significantly shorter in favor of LRA.

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