BACKGROUND: Transradial access has gained greater acceptance and interest due to the lower incidence of bleeding and local vascular complications and greater comfort for the patient. In centers where it is used as the preferred access, repeat transradial procedures are becoming routine. This study is aimed at assessing the safety, efficacy and limitations of repeated procedures in the daily practice. METHOD: Consecutive patients undergoing diagnostic coronary procedures using the transradial access were included in a prospective registry. Those who used the radial access more than once (group I) were compared with those who used it at one time only (group II). The success of the technique, procedural and fluoroscopic times, vascular complications and major adverse cardiovascular events were evaluated. In addition, in group I we obtained the frequency, success and limitations in the number of repeated procedures. RESULTS: From May 2008 to December 2009, 232 patients with previous right transradial access underwent diagnostic coronary procedures using the same access route and were compared to 1,857 patients who used it at one time only. The procedure success rate (99.5% vs. 98.1%; P = 0.17), the procedural time (15.78 ± 6.8 min vs. 15.54 ± 7.7 min; P = 0.62) and fluoroscopic time (3.26 ± 3.01 min vs. 3.26 ± 2.42 min; P > 0.99) were similar between groups. The procedure success rate did not differ among group I patients with > 2 repetitions, when compared with those who used it at one time only (99.2% vs. 100%; P = 0.99). In the late follow-up of group I patients, 602 procedures were carried out with a success rate of 98.9%, although there was a non-significant decrease of the success rate after each repetition up to the fourth procedure. CONCLUSION: The reuse of transradial access in diagnostic coronary procedures has proven to be effective, taking into consideration its high success rate and low complication rates in most of the patients, despite the limitation in the number of repetitions after each additional procedure.
Radial artery; Coronary angiography
