The Feasibility of Bypass Graft Angiography by Right Radial Access

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.