Novel diagnostic catheter specifically designed for both coronary arteries via the right transradial approach

Abstract

The aim of this study was to assess the feasibility, safety, and performance of a novel diagnostic catheter specifically designed for engaging both coronary arteries via the right transradial artery approach. A total of 160 patients were randomized between the standard Judkins (5F R4, L4; Cordis Corporation, Miami, FL) and the 5F Tiger II (Terumo Corporation, Tokyo, Japan) catheters. End points included the duration of various procedures and the assessments of angiographic image quality and catheter performance. The Tiger II was associated with a significantly shorter (40%) total procedure time (199.6+/-50.2 vs. 331.5+/-72.9 s, p=0.001) and a 33% shorter total fluoroscopic time (93.1+/-33.8 vs. 138.2+/-47.6 s, p=0.001) for diagnostic coronary angiography, compared with those with the Judkins catheter. There was no significant difference between the Tiger II and Judkins catheters for left coronary angiographic quality (left anterior descending, 2.82+/-0.48 vs. 2.94+/-0.29, p=0.084; left circumflex, 2.90+/-0.38 vs. 2.87+/-0.44, p=0.629). The Tiger II provided superior right coronary angiograms, compared with the Judkins catheter (2.99+/- 0.11 vs. 2.82+/-0.48, p=0.003). For the left coronary angiograms, the initial randomized catheter completed the procedure in 91% of the patients with the Tiger II and in 98% with the Judkins (p=0.167) catheters. For the right coronary angiograms, 100% were completed with the Tiger II and 95% with the Judkins (p=0.120) catheters. There were no angiographic or clinical complications in either group, so the procedural success rate was 100%. The potential of the Tiger II catheter for use as a multipurpose catheter for right transradial coronary angiography to reduce procedural and X-ray times to the level of classic transfemoral coronary angiography has to be confirmed in a randomized study.

Efficacy and indications of transradial and transfemoral approaches for peripheral artery stent implantation

“…We previously found that a single 5F multipurpose catheter via the TRA had no effect on the coronary angiography success rate (8), a finding confirmed in the present study on peripheral artery angiography. Although treatment with nitroglycerin (100 µg) and lidocaine (200 µg) could reduce the incidence of radial artery spasm (20,21), use of a single multipurpose catheter may also avoid radial artery spasm (8,22). Since the path from the right radial to the renal artery is long and extends across the aortic arch, the length of a multipurpose catheter is sometimes insufficient (8,23).…”

Successful Percutaneous Coronary Intervention of an Anomalous Right Coronary Artery with High Anterior Takeoff Using TIG Catheter From Trans-Femoral Approach

“…Therefore, a long tipped catheter is used for left coronary artery and a short tipped catheter is used for right coronary artery. 11 In case of anomalous RCA with high anterior takeoff short tipped right catheters don't reach the ostium and left catheters don't provide adequate back-up, as they tend to maintain their original configuration to the right side of ascending aorta. However, TIG catheter due to its versatile design rests against the posterior wall of ascending aorta and long tip easily reaches the ostium.…”

Performance of single reshaped Judkins left catheter for transradial coronary angiography

“…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].…”