Comparison of Right and Left Upper Limb Arterial Variants in XXXX Undergoing Bilateral Transradial Procedures.

@entity432 @entity1
BACKGROUND: Transradial approach (TRA), when compared with transfemoral, improves the safety of percutaneous coronary procedures. @entity432 variants are known to hinder the performance of transradial approach percutaneous coronary procedures. Data on the occurrence of @entity432 variants in the right and left arm arterial axes of individual @entity1 are lacking. METHODS AND RESULTS: From a single-center prospective registry, we selected all @entity1 in whom bilateral upper limb arterial anatomy was assessed based on the performance of left and right radial catheterization obtained during the same or during repeat coronary diagnostic or interventional procedure(s). The occurrence of upper right and left limb @entity432 variants was classified according to the previously described operative ABC classification. A total of 610 @entity1 were identified. An ABC upper limb @entity432 variant was detected in 156 (25.6%) @entity1 . Variants were right-sided only in 65 (11.0%), left-sided only in 40 (6.6%), and bilateral in 46 (7.5%) @entity1 . Thus, @entity432 variants were significantly more common in the right side (P=0.02). Bilateral arterial variants were significantly associated with age, female sex, and valvulopathy. Both A (radial/brachial) and B (axillary/subclavian/innominate) variants exhibited concordance across the 2 sides (odds ratio, 7.2; 95% confidence interval, 4.1-12.7 and 8.0; 95% confidence interval, 2.1-30.9, respectively). CONCLUSIONS: The occurrence of an anatomic variant potentially hindering transradial approach coronary diagnostic or interventional procedures is bilateral in <8% of cases and is more common in the right arm. Such information may guide, during the clinical practice, the access selection in the case of repeat procedures or need for additional accesses.
