Author + information
- Received March 10, 2010
- Revision received July 9, 2010
- Accepted July 25, 2010
- Published online October 1, 2010.
- Olivier F. Bertrand, MD, PhD⁎,⁎ (, )
- Sunil V. Rao, MD†,
- Samir Pancholy, MD‡,
- Sanjit S. Jolly, MD, MSc§,
- Josep Rodés-Cabau, MD⁎,
- Éric Larose, DVM, MD⁎,
- Olivier Costerousse, PhD⁎,
- Martial Hamon, MD∥ and
- Tift Mann, MD¶
- ↵⁎Reprint requests and correspondence:
Dr. Olivier F. Bertrand, Interventional Cardiology Laboratories, Institut universitaire de cardiologie et de pneumologie de Québec, 2725 chemin Sainte Foy, Québec (QC) G1V 4G5, Canada
Objectives The aim of this study was to evaluate practice of transradial approach (TRA).
Background TRA has been adopted as an alternative access site for coronary procedures.
Methods A questionnaire was distributed worldwide with Internet-based software.
Results The survey was conducted from August 2009 to January 2010 among 1,107 interventional cardiologists in 75 countries. Although pre-TRA dual hand circulation testing is not uniform in the world, >85% in the U.S. perform Allen or oximetry testing. Right radial artery is used in almost 90%. Judkins catheters are the most popular for left coronary artery angiographies (66.5%) and right coronary artery angiographies (58.8%). For percutaneous coronary intervention (PCI), 6-F is now standard. For PCI of left coronary artery, operators use standard extra back-up guiding catheters in >65% and, for right coronary artery 70.4% use right Judkins catheters. Although heparin remains the routine antithrombotic agent in the world, bivalirudin is frequently used in the U.S. for PCI. The incidence of radial artery occlusion before hospital discharge is not assessed in >50%. Overall, approximately 50% responded that their TRA practice will increase in the future (68.4% in the U.S.).
Conclusions TRA is already widely used across the world. Diagnostic and guiding-catheters used for TRA remain similar to those used for traditional femoral approach, suggesting that specialized radial catheters are not frequently used. However, there is substantial variation in practice as it relates to specific aspects of TRA, suggesting that more data are needed to determine the optimal strategy to facilitate TRA and optimize radial artery patency after catheterization.
Drs. Bertrand and Larose are research-scholars of Quebec Foundation for Health Research. Dr. Bertrand has provided consulting services for Cordis. Dr. Rao is a consultant for and has received honoraria from Terumo Corp. Dr. Pancholy is a consultant for Terumo Corp. and Medtronic. Dr. Jolly has received grant support from Medtronic, and speakers' honoraria from GlaxoSmithKline and Sanofi-Aventis. Dr. Hamon has provided lectures and consultancy for Cordis and Terumo Corp. All other authors have reported that they have no relationships to disclose.
- Received March 10, 2010.
- Revision received July 9, 2010.
- Accepted July 25, 2010.
- American College of Cardiology Foundation