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. 2022 Nov 10;22(1):479.
doi: 10.1186/s12872-022-02933-x.

Correlation of a guidewire maximum insertion length with tortuous radial artery and the success rate during transradial coronary angiography

Hongsong Li #  1 , Xia Chen #  1 , Shuang Sha #  2   3 , Xiangdong Xu  4 , Yingmin Chen  5
Affiliations

Correlation of a guidewire maximum insertion length with tortuous radial artery and the success rate during transradial coronary angiography

Hongsong Li et al. BMC Cardiovasc Disord. .

Abstract

Background: Percutaneous coronary intervention (PCI) is a safe and effective therapy for patients with obstructive coronary artery disease (CAD). We aimed to assess the correlation between the success rate of angiography and the maximum insertion length and resistance of a soft-tipped guidewire.

Methods: Five hundred twenty-one patients were treated by successful radial artery puncture. According to whether the guidewire resistance, the patients were divided to three groups. 17 patients were maximum insertion length of guidewire ≤ 30 cm when resistance was encountered (group 1). 17 patients were maximum insertion length of guidewire between 30 and 45 cm when resistance was encountered (group 2). 487 patients were no resistance encountered (group 3).

Results: The coronary angiography success rates of group 1, 2, and 3 were 52.94%, 47.05%, 98.97%, respectively. Typically, angiography can be completed in patients with Ω-shaped, S-shape or Z-shaped tortuosity.

Conclusions: The maximum insertion length of straight guidewire and resistance can be used to determine radial artery status. The radial artery tortuosity or spasm significantly affects the success rate of coronary angiography.

Keywords: Coronary angiography; Guidewire; Radial artery.

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Conflict of interest statement

We have no potential conflicts of interest to declare.

Figures

Fig. 1
Fig. 1
Flow diagram of radial coronary angiography of the patients
Fig. 2
Fig. 2
Retrograde angiogram showed the vessel tortuosity or spasms of upper limb artery (the radial artery or the brachial artery) when resistance of a straight, soft-tipped guidewire was encountered. A The radial artery spasms. B An acute angled (Ω-shape) of the radial artery. C A wavy tortuosity (S-shape) of the radial artery. D An annular tortuosity (α-shape) of the radial artery. E Annular tortuosity (α-shape) was present in the proximal segment of the radial artery and the small accessory brachial artery was present. F Annular tortuosity (α-shape) of the brachial artery. G Z-shaped tortuosity of the radial artery. H Z-shaped tortuosity was present in the proximal segment of the radial artery and the small accessory brachial artery was present
See this image and copyright information in PMC

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