Comparison Between Right and Left Radial Approach in Patients Undergoing Percutaneous Coronary Procedures

June 2, 2025 updated by: Kerillos Alfy Ayoub Salib, Assiut University
Our aim is to compare between right and left radial approach in patients undergoing percutaneous coronary procedures regarding feasibility and complications.

Study Overview

Status

Completed

Conditions

Intervention / Treatment

Detailed Description

The radial artery has progressively became the standard access site for percutaneous coronary procedures both diagnostic and interventional. The first trans-radial access for cardiovascular diagnostics dates to 1947.

In 1989, the first case series of 100 coronary angiographies performed through the radial access, demonstrating the safety and the fast mobilization of patients with the radial approach .

The main advantages of the radial approach are increased safety and comfort of the patients with reduction of bleeding complications and immediate post-procedure ambulation .with these advantages, current guidelines highly recommend radial access for coronary angiography and percutaneous coronary intervention.

Most clinical trials focused solely on the right radial approach and rarely consider the left radial approach. Indeed, the RRA has technical obstacles related to anatomy and clinical practice like increased incidence of tortuosity of the subclavian artery and radial-ulnar artery loop with the right radial approach.

Most operators use the right radial access as the left radial access increase operator discomfort during vascular access and procedure, especially in obese patients.

However, the left radial access has potential benefits for both the patient and operator. One of which is that the left radial approach is associated with lower fluoroscopy time compared with the right radial approach.

Left radial artery as well is an appropriate alternative access for coronary catheterization with less anatomical variations like tortuosity than the right radial artery Moreover, left radial access is preferred for right handed patients because of temporary post-procedural disability caused by hemostasis process in right radial artery access Also subclavian artery tortuosity is significantly more common on the right side and is an important cause of difficult, prolonged, or failed radial procedure.

Study Type

Observational

Enrollment (Actual)

100

Contacts and Locations

This section provides the contact details for those conducting the study, and information on where this study is being conducted.

Study Locations

  • Egypt
      • Assiut, Egypt
        • Assiut University

Participation Criteria

Researchers look for people who fit a certain description, called eligibility criteria. Some examples of these criteria are a person's general health condition or prior treatments.

Eligibility Criteria

Ages Eligible for Study

18 years to 110 years (Adult, Older Adult)

Accepts Healthy Volunteers

No

Sampling Method

Non-Probability Sample

Study Population

Patients undergoing coronary angiography or elective PCI in assiut university heart hospital.

Description

Inclusion Criteria:

  • • All patients presented to assiut university cardiac catheterization laboratory and eligible for radial coronary procedures (either diagnostic or interventional )

Exclusion Criteria:

  • • Patients with acute coronary syndrome.

    • Patients with chronic upper limb ischemia
    • Patients with AV fistula
    • Patients with severe renal impairment
    • Failure to successfully cannulate the radial artery

Study Plan

This section provides details of the study plan, including how the study is designed and what the study is measuring.

How is the study designed?

Design Details

  • Observational Models: Other
  • Time Perspectives: Prospective

Cohorts and Interventions

Group / Cohort
Intervention / Treatment
Right Radial Group
Other: Coronary angiography and percutaneous coronary intervention
Coronary angiography and percutaneous coronary intervention via radial approach
Left Radial Group
Other: Coronary angiography and percutaneous coronary intervention
Coronary angiography and percutaneous coronary intervention via radial approach

What is the study measuring?

Primary Outcome Measures

Outcome Measure
Measure Description
Time Frame
Comparison between right and left radial approach in patients undergoing percutaneous coronary Procedures , is there is difference in tortuosity of the radial and subclavian arteries between both approaches ?
Time Frame: Baseline

To compare the incidence of tortuosity in the radial and subclavian arteries between the right vs left radial approach.

.
Baseline
Comparison between right and left radial approach in patients undergoing percutaneous coronary Procedures regarding easiness of cannulation of left main coronary artery and right coronary artery tortuosity by assessing time needed for cannulation
Time Frame: baseline
To compare the easiness of cannulation of left main (LM ) coronary artery and right coronary artery (RCA) via the two approaches by assessing time needed by the guiding wire and catheter to reach the ostia of either the left main coronary artery and right coronary artery .
baseline
Comparison between right and left radial approach in patients undergoing percutaneous coronary Procedures , is there is possible difference in the incidence of complications via the two approaches?
Time Frame: baseline
To compare the incidence of complications e.g (bleeding , pseudoaneurysm formation ,e.t.c ) between the right and left radial approaches .
baseline
Comparison between right and left radial approach in patients undergoing percutaneous coronary Procedures regarding the incidence of crossover between right and left radial approaches and between radial and femoral approach .
Time Frame: baseline
To compare the incidence of crossover between right and left radial arteries and femoral approach in case of marked radial spasm .
baseline

Collaborators and Investigators

This is where you will find people and organizations involved with this study.

Sponsor

Assiut University

Publications and helpful links

The person responsible for entering information about the study voluntarily provides these publications. These may be about anything related to the study.

General Publications

Study record dates

These dates track the progress of study record and summary results submissions to ClinicalTrials.gov. Study records and reported results are reviewed by the National Library of Medicine (NLM) to make sure they meet specific quality control standards before being posted on the public website.

Study Major Dates

Study Start (Actual)

November 15, 2022

Primary Completion (Actual)

December 15, 2024

Study Completion (Actual)

April 15, 2025

Study Registration Dates

First Submitted

November 3, 2022

First Submitted That Met QC Criteria

November 23, 2022

First Posted (Actual)

November 25, 2022

Study Record Updates

Last Update Posted (Actual)

June 4, 2025

Last Update Submitted That Met QC Criteria

June 2, 2025

Last Verified

November 1, 2024

More Information

Terms related to this study

Additional Relevant MeSH Terms

Other Study ID Numbers

  • Coronary procedures

Plan for Individual participant data (IPD)

Plan to Share Individual Participant Data (IPD)?

NO

Drug and device information, study documents

Studies a U.S. FDA-regulated drug product

No

Studies a U.S. FDA-regulated device product

No

product manufactured in and exported from the U.S.

No

This information was retrieved directly from the website clinicaltrials.gov without any changes. If you have any requests to change, remove or update your study details, please contact register@clinicaltrials.gov. As soon as a change is implemented on clinicaltrials.gov, this will be updated automatically on our website as well.

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