G. M. Zhang et al. / World Journal of Cardiovascular Diseases 3 (2013) 581-584 583
81.25%. While 80 of 95 patients were completed the
procedure with a BRACT catheter, yielding a procedure
success rate of 84.21%. The procedure success rate in the
Judkins group showed no significant difference com-
pared with that in the BRACT group (P = 0.70) (Table
2).
Total fluoroscopic time was 4.28 ± 0.48 min in Jud-
kins group, and 4.21 ± 0.43 min in BRACT grou p. There
were no significant difference in total fluoroscopic time
between the two groups (P = 0.29) (Table 2).
No significantly statistical differences between the
groups regarding to radial artery spasm and angiographic
or clinical complications (Table 2).
3.3. Success Rates of Single Reshaped Judkins
Left Catheter
Of the 1873 patients, 1869 patients were eligible for the
study. Overall, 1408 cases (75.33%) were performed
both left and right coronary angiography with only one
reshaped Judkins left catheter, and 459 cases (24.56%)
were performed with two catheters because the Judkins
left catheter couldn’t reach to right coronary artery
Table 1. Baseline patient’s characteristics.
Judkins group
(n = 96) BRACT group
(n = 95) P-values
Age (years) 56.0 ± 9.9 57.1 ± 8.9 0.17
Male gender (n (%)) 68 (70.8) 73 (76.8) 0.06
Hemoglobin (g/l) 130.1 ± 11.2 135.3 ± 12.6 0.16
BMI (kg/m2) 25.3 ± 3.59 25.7 ± 3.10 0.08
Risk factors (n (%))
Hypertension 64 (66.7) 66 (69.5) 0.36
Hyperlipidemia 29 (30.2) 33 (34.7) 0.26
Diabetes mellitus 20 (20.8) 22 (23.2) 0.33
Smoking 52 (54.2) 52 (54.7) 0.97
Values are expressed as mean ± SD or n (%). P-values derived from inde-
pendent sample t-test for continuous variables or x2 test for categorical
variables. BMI: body mass index.
Table 2. Safety and efficacy between Judkins group and BRA-
CT group.
Judkins group
(n = 96) BRACT group
(n = 95) P values
Success rates (n (%)) 78 (81.25) 80 (84.21) 0.70
Fluoroscopic time (min) 4.28 ± 0.48 4.21 ± 0.43 0.29
Complications (n (%)) 0 (0) 0 (0) 1.00
Values are expressed as mean ± SD or n (%). P-values derived from inde-
pendent sample t-test for continuous variables or x2 test for categorical
variables.
ostium. The other 2 cases had abnormal right coronary
artery ostium that the Judkins right catheter couldn’t
reach to right coronary artery ostium, so we had to use
the Amplatz Right (AR) catheter to reach to right coro-
nary artery ostium.
4. DISCUSSION
In recent years, the transradial approach has been used
increasingly as an alternative to femoral approach for
percutaneous coronary diagnosis and intervention. Most
of the diagnostic catheters that are currently used for
transradial coronary angiography are the Judkins, Am-
platz, which have curves originally designed for a fe-
moral approach. The technical and anatomic aspects of
transradial access are different from those of femoral
access, thus making manipulation of conventional diag-
nostic catheters sometimes difficult an d time-consuming.
Therefore, many attempts have been made to design a
catheter for a transradial approach for routine diagnostic
and interventional coronary procedures, trying to engage
both coronary arteries by one single catheter [3]. For
example, the 5F Tiger II (Terumo Corporation, Tokyo,
Japan) catheters were tested to prove the feasibility,
safety, and performance as a kind of multipurpose
catheter for transradial coronary angiography [4]. The
Brachial Type K (Terumo Outlook, Leuven, Belgium)
catheters were also proved to to perform both left and
right coronary angiography with a single catheter [5].
The diagnostic catheter that currently used for tran-
sradial coronary angiography in most hospitals in China
is the multipurpose brachial type catheter (BRACT).
BRACT catheter is more costly than Judkins, which
limits the useage of BRACT catheter to some extent.
This study demonstrated the feasibility and safety of
single reshaped Judkins left catheter for engaging both
coronary arteries via the right transradial artery ap-
proach.
The present study showed that by using a reshaped
Judkins left catheter, it was possible to successfully per-
form both left and right coronary angiography in 75.33%
of the cases, which was very similar to conventional
radial catheter with respect to procedure success rate and
fluoroscopic time. Moreover, there were no instances of
aortic or coronary dissection. The manipulation of diag-
nostic catheters also did not lead to excessive spasm.
According to our experien ce, the 5F Judkins left catheter
was more suitable for reshaping, although the 6F catheter
can also be reshaped. Another advantage by using a
reshaped Judkins left catheter was that this reshaped
catheter didn’t need a guidewire support for engaging
either the right or the left coronary arteries, even when
the initial attempt for engaging failed. This will simplify
the manipulation and reduce the potential complications
related to guidewire exchange.
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