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. 2018 Jan 2;13(1):e0189899.
doi: 10.1371/journal.pone.0189899. eCollection 2018.

Efficacy of a one-catheter concept for transradial coronary angiography

Christoph Langer  1   2 , Julia Riehle  1 , Helge Wuttig  3 , Stephanie Dürrwald  3 , Helmut Lange  2 , Alexander Samol  3 , Norbert Frey  1 , Marcus Wiemer  3
Affiliations

Efficacy of a one-catheter concept for transradial coronary angiography

Christoph Langer et al. PLoS One. .

Abstract

Introduction: Transradial coronary angiography (TRC) can be performed with a one-catheter approach for the right and left coronary ostium (R/LCO). We investigated the performance of a special diagnostic catheter widely used for the one-catheter-approach, the Tiger (Tiger II, TerumoTM).

Methods: In a dual center registry we analyzed 1412 TRC-procedures exclusively performed by experienced TRC-operators. We compared the performance of the Tiger with Judkins catheters by retrospectively judging ostial catheter stability during contrast injection, and by measuring contrast use, fluoroscopy time (FT) and complication rate.

Results: Poor or failed ostial engagement was found in 40.5% in the Tiger group, compared to 46.6% with the use of Judkins catheters (p<0.183). Ostial instability of the Tiger was found more often during engagement of the LCO than the RCO (34.4% vs. 10.8%, p<0.001), whereas it was similar in the LCO and RCO for Judkins catheters (27.4% vs. 26.7%, p = 0.840). TRC-procedures performed with Tiger catheters were associated with less contrast volume (63.48 ± 29.83mL vs. 82.51 ± 56.58mL, p<0.004) and shorter FT than with Judkins catheters. (198.27 ± 194.8sec vs. 326.85 ± 329.70sec). Forearm hematomas occurred less often with the Tiger (1.2% vs. 6.6%, p< 0.02).

Conclusion: The Tiger employed as a single catheter in TRC is an effective tool to achieve lower contrast volume and fluoroscopy time at a low complication rate. Unstable engagement affects predominantly the left coronary artery, but its overall frequency is similar for both, the Tiger and Judkins catheters.

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Conflict of interest statement

Competing Interests: The authors have declared that no competing interests exist.

Figures

Fig 1
Fig 1. Ostial stability of the Tiger.
The bar graph shows the distribution of stable (left), completely unstable (mid) and partially unstable (right) ostial catheter landing when using the Tiger and the Judkins catheters. “Stable” means stable ostial landing in both coronary ostia; “unstable” means instable ostial landing in both ostia. “Partially unstable” means unstable ostial landing in the RCO or LCO.
Fig 2
Fig 2. Distribution of ostial stability of the Tiger and Judkins catheters.
The bar graph demonstrates the distribution of ostial instability within the RCO and LCO when using the Tiger and the Judkins catheters. Tiger vs. Judkins in the LCO p = 0.108, Tiger vs. Judkins in the RCO p<0.001, Judkins LCO vs. Judkins in the RCO p = 0.840, Tiger LCO vs. Tiger in the RCO p<0.001.
Fig 3
Fig 3. Dye volume and fluoroscopy time.
The left bar graph demonstrates the volume of contrast medium applied by the Tiger and Judkins catheters in case of stable and unstable ostial landing (not normally distributed data); Tiger: p = 0.004, Judkins: p = 0.075. The right bar graph shows FT applied under the use of the Tiger and the Judkins in case of stable and instable ostial landing (not normally distributed data): Tiger p = 0.024, Judkins p = 0.255.
See this image and copyright information in PMC

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