A Comparison of Three Commonly Used Catheter Strategies in Diagnostic Transradial Coronary Angiography

The transradial technique has become standard of care for coronary angiography and intervention. In the field of diagnostic coronary angiography, studies have compared single and dual catheter approaches, yet there is paucity of literature comparing all 3 commonly used strategies for transradial coronary angiography, Judkins (JU) dual catheters or single Tiger (T) or Jacky (JA) catheters. We aimed to assess the procedural performance of 3 commonly used catheter strategies. We conducted a single-center, randomized trial with 1:1:1 group allocation (T, JA, and JU as initial strategy) with patients undergoing elective right transradial coronary angiography performed by experienced operators. Primary endpoints included procedure time, contrast volume, and fluoroscopy time. A total of 99 patients were randomized: 33 were enrolled in the T-study group, 33 in the JA group, and 33 in the JU group. Median contrast volume utilization was significantly lower in the T group relative to the other groups ([T: 40 mL {35 to 50 mL}, JA: 50 mL {40 to 59 mL}, JU: 55 mL {45 to 60 mL}, p = 0.04]). The Tiger group was noted to have significantly lower times total procedural time (T: 9.2 minute [6.92 to 11.3 minute], JA: 11.92 minute [8.2 to 17.57 minute], JU: 12.8 minute [10.3 to 15.58 minute], p = 0.003). However, there was no difference in fluoroscopy time (T: 2.8 minute [2.17 to 5.6 minute], JA: 4.35 minute [2.7 to 7.43 minute], JU: 4.3 minute [3.1 to 7.1 minute], p = 0.08).