Feasibility and safety of concomitant left internal mammary arteriography at the setting of the right transradial coronary angiography

We investigated the feasibility and safety of concomitant left internal mammary artery (LIMA) angiography at the setting of the right transradial coronary angiography (TRCA). LIMA angiography was performed using a 5 Fr Simmons-type catheter with a newly modified tip in 184 consecutive patients. The catheter was reformed in the descending (new method) or ascending (traditional method) aorta and manipulated to cannulate the left subclavian artery and LIMA orifice. LIMA angiography was performed selectively in 164 patients (89%) and semiselectively (when the catheter tip reached and was directed to the mammary artery orifice) in 20 patients. There were no procedure-related complications. The image quality of all the semiselective angiograms was also determined satisfactory. Total procedural time was 223 +/- 168 sec. The catheter was reformed using the new method in 160 patients (87%). The catheter reformation time and total procedure time were significantly shorter with the new method than with the traditional method (18 +/- 8 vs. 117 +/- 115 sec, p = 0.000; 204 +/- 191 vs. 309 +/- 139 sec, p = 0.021, respectively). In conclusion, LIMA angiography can be performed readily and safely at the setting of the right TRCA using a Simmons-type catheter. The image quality of the LIMA angiograms is sufficient to obviate the need of the second preoperative angiography via another route.