Coronary Artery DiseaseNCT05626660
Comparison Between Right and Left Radial Approach in Patients Undergoing Percutaneous Coronary Procedures
An observational study of Coronary Artery Disease, run by Assiut University at 1 site in Egypt.
Trial summary
Our aim is to compare between right and left radial approach in patients undergoing percutaneous coronary procedures regarding feasibility and complications. Read more about this study
- Who is it for?
- Ages 18 to 110 years
- Conditions the study is for
- Coronary Artery Disease
- What is being tested?
- Coronary angiography and percutaneous coronary intervention
- How many people
- 100 participants
- Where
- 1 siteEgypt
- Study dates
- 15 Nov 2022to 15 Apr 2025
- Phase
- Observational
- Are there results?
- None posted in the registry
Key requirements
Who can take part, as listed by the sponsor. Only the study team can confirm whether you are eligible, so take this list to your doctor.
- Ages 18 to 110 years
- All sexes
- No healthy volunteers
- Adult, Older adult
Study population: Patients undergoing coronary angiography or elective PCI in assiut university heart hospital.
Who may be able to join
- • All patients presented to assiut university cardiac catheterization laboratory and eligible for radial coronary procedures (either diagnostic or interventional )
Who cannot join
- • Patients with acute coronary syndrome.
- Patients with chronic upper limb ischemia
- Patients with AV fistula
- Patients with severe renal impairment
- Failure to successfully cannulate the radial artery
Trial locations and contacts
1 site in 1 country.
About this study
Our aim is to compare between right and left radial approach in patients undergoing percutaneous coronary procedures regarding feasibility and complications.
Read the detailed description
The radial artery has progressively became the standard access site for percutaneous coronary procedures both diagnostic and interventional. The first trans-radial access for cardiovascular diagnostics dates to 1947.
In 1989, the first case series of 100 coronary angiographies performed through the radial access, demonstrating the safety and the fast mobilization of patients with the radial approach .
The main advantages of the radial approach are increased safety and comfort of the patients with reduction of bleeding complications and immediate post-procedure ambulation .with these advantages, current guidelines highly recommend radial access for coronary angiography and percutaneous coronary intervention.
Most clinical trials focused solely on the right radial approach and rarely consider the left radial approach. Indeed, the RRA has technical obstacles related to anatomy and clinical practice like increased incidence of tortuosity of the subclavian artery and radial-ulnar artery loop with the right radial approach.
Most operators use the right radial access as the left radial access increase operator discomfort during vascular access and procedure, especially in obese patients.
However, the left radial access has potential benefits for both the patient and operator. One of which is that the left radial approach is associated with lower fluoroscopy time compared with the right radial approach.
Left radial artery as well is an appropriate alternative access for coronary catheterization with less anatomical variations like tortuosity than the right radial artery Moreover, left radial access is preferred for right handed patients because of temporary post-procedural disability caused by hemostasis process in right radial artery access Also subclavian artery tortuosity is significantly more common on the right side and is an important cause of difficult, prolonged, or failed radial procedure.
- Conditions
- Coronary Artery Disease
- Being tested
- Coronary angiography and percutaneous coronary intervention
- Medical subject headings
- Coronary Artery Disease
What participants receive
What participants receive. In a randomised study each person is assigned to one group by chance.
Coronary angiography and percutaneous coronary interventionOther
Coronary angiography and percutaneous coronary intervention via radial approach
| Study group | Role | What they receive |
|---|---|---|
| Right Radial Group | Not described Receives: Other: Coronary angiography and percutaneous coronary intervention | |
| Left Radial Group | Not described Receives: Other: Coronary angiography and percutaneous coronary intervention |
What is being measured
The primary outcome is the main question the study is designed to answer.
Comparison between right and left radial approach in patients undergoing percutaneous coronary Procedures , is there is difference in tortuosity of the radial and subclavian arteries between both approaches ?
To compare the incidence of tortuosity in the radial and subclavian arteries between the right vs left radial approach.
.
Measured: Baseline
Comparison between right and left radial approach in patients undergoing percutaneous coronary Procedures regarding easiness of cannulation of left main coronary artery and right coronary artery tortuosity by assessing time needed for cannulation
To compare the easiness of cannulation of left main (LM ) coronary artery and right coronary artery (RCA) via the two approaches by assessing time needed by the guiding wire and catheter to reach the ostia of either the left main coronary artery and right coronary artery .
Measured: baseline
Comparison between right and left radial approach in patients undergoing percutaneous coronary Procedures , is there is possible difference in the incidence of complications via the two approaches?
To compare the incidence of complications e.g (bleeding , pseudoaneurysm formation ,e.t.c ) between the right and left radial approaches .
Measured: baseline
Comparison between right and left radial approach in patients undergoing percutaneous coronary Procedures regarding the incidence of crossover between right and left radial approaches and between radial and femoral approach .
To compare the incidence of crossover between right and left radial arteries and femoral approach in case of marked radial spasm .
Measured: baseline
Timeline
From the start of the study to its completion; the mark is today. Estimated dates are the sponsor’s plan.
- First posted25 Nov 2022
- Study start15 Nov 2022
- Primary completion15 Dec 2024
- Study completion15 Apr 2025
Resources
- Official record on ClinicalTrials.govThe registry entry this page is built from, with its full change history.
- Publications (10)Papers the sponsor has linked to this study.
- Other trials for Coronary Artery DiseaseStudies of the same condition, open and under way.
- More trials run by Assiut UniversityThe sponsor's other registered studies.
- What the trial phases meanHow a treatment moves from first tests in people to approval.
More details
For doctors and researchers: how the study is designed, who runs it, and its registry IDs.
Study design
- Study type
- Observational
- Observational model
- Other
- Time perspective
- Cross-sectional
- Enrolment
- 100 participants (actual)
Sponsor and investigators
- Lead sponsor
- Assiut University
- Sponsor type
- University, hospital or other
- Responsible party
- Principal investigator, Kerillos Alfy Ayoub Salib, Assiut University
IDs, dates and publications
- ClinicalTrials.gov ID
- NCT05626660
- Sponsor's protocol ID
- Coronary procedures
- Status last verified
- Nov 2024
- First submitted
- 3 Nov 2022
- Last updated
- 4 Jun 2025
- Results posted
- No
- Data monitoring committee
- No
- FDA-regulated drug
- No
- FDA-regulated device
- No
- Individual data sharing
- No
Publications
Daralammouri Y, Nazzal Z, Mosleh YS, Abdulhaq HK, Khayyat ZY, Hamshary YE, Azamtta M, Ghanim A, Awwad F, Majadla S, Maree M, Hamaida J, Ismail Y. Distal Radial Artery Access in comparison to Forearm Radial Artery Access for Cardiac Catheterization: A Randomized Controlled Trial (DARFORA Trial). J Interv Cardiol. 2022 Jul 15;2022:7698583. doi: 10.1155/2022/7698583. eCollection 2022.
PubMed 35911661Kiemeneij F. Left distal transradial access in the anatomical snuffbox for coronary angiography (ldTRA) and interventions (ldTRI). EuroIntervention. 2017 Sep 20;13(7):851-857. doi: 10.4244/EIJ-D-17-00079.
PubMed 28506941Lee OH, Roh JW, Im E, Cho DK, Jeong MH, Choi D, Kim Y. Feasibility and Safety of the Left Distal Radial Approach in Percutaneous Coronary Intervention for Bifurcation Lesions. J Clin Med. 2021 May 19;10(10):2204. doi: 10.3390/jcm10102204.
PubMed 34069701Klimek K, Swiatek M, Klocek K, Tworek M, Zwolski M, Milewski K, Janas A. Comparison of Safety and Efficiency between Tiger-2 Catheter with Right Radial Artery Access and Judkins Catheter with Left Radial Artery Access. J Clin Med. 2021 Sep 6;10(17):4020. doi: 10.3390/jcm10174020.
PubMed 34501468Burzotta F, Trani C, De Vita M, Crea F. A new operative classification of both anatomic vascular variants and physiopathologic conditions affecting transradial cardiovascular procedures. Int J Cardiol. 2010 Nov 5;145(1):120-2. doi: 10.1016/j.ijcard.2009.06.025. Epub 2009 Jul 17.
PubMed 19616324Dehghani P, Mohammad A, Bajaj R, Hong T, Suen CM, Sharieff W, Chisholm RJ, Kutryk MJ, Fam NP, Cheema AN. Mechanism and predictors of failed transradial approach for percutaneous coronary interventions. JACC Cardiovasc Interv. 2009 Nov;2(11):1057-64. doi: 10.1016/j.jcin.2009.07.014.
PubMed 19926044Kawamura Y, Yoshimachi F, Nakamura N, Yamamoto Y, Kudo T, Ikari Y. Impact of dedicated hemostasis device for distal radial arterial access with an adequate hemostasis protocol on radial arterial observation by ultrasound. Cardiovasc Interv Ther. 2021 Jan;36(1):104-110. doi: 10.1007/s12928-020-00656-4. Epub 2020 Mar 12.
PubMed 32166728Abdelazeem B, Abuelazm MT, Swed S, Gamal M, Atef M, Al-Zeftawy MA, Noori MA, Lutz A, Volgman AS. The efficacy of nitroglycerin to prevent radial artery spasm and occlusion during and after transradial catheterization: A systematic review and meta-analysis of randomized controlled trials. Clin Cardiol. 2022 Dec;45(12):1171-1183. doi: 10.1002/clc.23906. Epub 2022 Nov 6.
PubMed 36335609Kiemeneij F, Burzotta F, Fajadet J. Thirty years of transradial coronary interventions. EuroIntervention. 2022 May 15;18(1):19-21. doi: 10.4244/EIJ-E-22-00009. No abstract available.
PubMed 35570688RADNER S. Thoracal aortography by catheterization from the radial artery; preliminary report of a new technique. Acta Radiol (Stockh). 1948 Feb 28;29(2):178-80. doi: 10.3109/00016924809132437. No abstract available.
PubMed 18908938
Study at a glance
From the registry record, last updated by the sponsor on 4 Jun 2025. Recruitment status is as the sponsor reported it: confirm with the study team.
- Official title
- Comparison Between Right and Left Radial Approach in Patients Undergoing Percutaneous Coronary Procedures
- ClinicalTrials.gov ID
- NCT05626660
- Acronym / sponsor ID
- Coronary procedures
- Conditions
- Coronary Artery Disease
- Study type
- Observational
- Recruitment status
- Completed
- Enrolment
- 100 participants (actual)
- Lead sponsor
- Assiut UniversityUniversity, hospital or other
- Study start
- 15 Nov 2022 (actual)
- Primary completion
- 15 Dec 2024 (actual)
- Study completion
- 15 Apr 2025 (actual)
- First posted
- 25 Nov 2022 (actual)
- Results
- Not posted in the source record
Clinical summary
The research question as the sponsor registered it. This describes what the study plans to test, not what it found.
Our aim is to compare between right and left radial approach in patients undergoing percutaneous coronary procedures regarding feasibility and complications.
Detailed description
The radial artery has progressively became the standard access site for percutaneous coronary procedures both diagnostic and interventional. The first trans-radial access for cardiovascular diagnostics dates to 1947.
In 1989, the first case series of 100 coronary angiographies performed through the radial access, demonstrating the safety and the fast mobilization of patients with the radial approach .
The main advantages of the radial approach are increased safety and comfort of the patients with reduction of bleeding complications and immediate post-procedure ambulation .with these advantages, current guidelines highly recommend radial access for coronary angiography and percutaneous coronary intervention.
Most clinical trials focused solely on the right radial approach and rarely consider the left radial approach. Indeed, the RRA has technical obstacles related to anatomy and clinical practice like increased incidence of tortuosity of the subclavian artery and radial-ulnar artery loop with the right radial approach.
Most operators use the right radial access as the left radial access increase operator discomfort during vascular access and procedure, especially in obese patients.
However, the left radial access has potential benefits for both the patient and operator. One of which is that the left radial approach is associated with lower fluoroscopy time compared with the right radial approach.
Left radial artery as well is an appropriate alternative access for coronary catheterization with less anatomical variations like tortuosity than the right radial artery Moreover, left radial access is preferred for right handed patients because of temporary post-procedural disability caused by hemostasis process in right radial artery access Also subclavian artery tortuosity is significantly more common on the right side and is an important cause of difficult, prolonged, or failed radial procedure.
Study design
- Observational model
- Other
- Time perspective
- Cross-sectional
- Number of arms
- 2
| Arm | Type | Receives |
|---|---|---|
| Right Radial Group | – | Other: Coronary angiography and percutaneous coronary intervention |
| Left Radial Group | – | Other: Coronary angiography and percutaneous coronary intervention |
Who may qualify
- Ages
- 18 to 110 years
- Sex
- All
- Healthy volunteers
- Not accepted
- Age groups
- Adult, Older adult
- Study population
- Patients undergoing coronary angiography or elective PCI in assiut university heart hospital.
Key inclusion criteria (1 listed)
- • All patients presented to assiut university cardiac catheterization laboratory and eligible for radial coronary procedures (either diagnostic or interventional )
Key exclusion criteria (5 listed)
- • Patients with acute coronary syndrome.
Eligibility is decided by the study team after screening; this overview does not establish that a patient qualifies. Full inclusion and exclusion criteria.
Interventions
| Intervention | Type | Arms |
|---|---|---|
| Coronary angiography and percutaneous coronary interventionCoronary angiography and percutaneous coronary intervention via radial approach | Other | Left Radial Group, Right Radial Group |
Primary outcome
Comparison between right and left radial approach in patients undergoing percutaneous coronary Procedures , is there is difference in tortuosity of the radial and subclavian arteries between both approaches ?
Time frame: Baseline
To compare the incidence of tortuosity in the radial and subclavian arteries between the right vs left radial approach. .
Comparison between right and left radial approach in patients undergoing percutaneous coronary Procedures regarding easiness of cannulation of left main coronary artery and right coronary artery tortuosity by assessing time needed for cannulation
Time frame: baseline
To compare the easiness of cannulation of left main (LM ) coronary artery and right coronary artery (RCA) via the two approaches by assessing time needed by the guiding wire and catheter to reach the ostia of either the left main coronary artery and right coronary artery .
Comparison between right and left radial approach in patients undergoing percutaneous coronary Procedures , is there is possible difference in the incidence of complications via the two approaches?
Time frame: baseline
To compare the incidence of complications e.g (bleeding , pseudoaneurysm formation ,e.t.c ) between the right and left radial approaches .
Comparison between right and left radial approach in patients undergoing percutaneous coronary Procedures regarding the incidence of crossover between right and left radial approaches and between radial and femoral approach .
Time frame: baseline
To compare the incidence of crossover between right and left radial arteries and femoral approach in case of marked radial spasm .
Results and safety
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
Research links
- Official record on ClinicalTrials.govLast updated by the sponsor 4 Jun 2025.
- Background: PubMed 35911661Daralammouri Y, Nazzal Z, Mosleh YS, Abdulhaq HK, Khayyat ZY, Hamshary YE, Azamtta M, Ghanim A, Awwad F, Majadla S, Maree M, Hamaida J, Ismail Y. Distal Radial Artery Access in comparison to Forearm Radial Artery Access for Cardiac Catheterization: A Randomized Controlled Trial (DARFORA Trial). J Interv Cardiol. 2022 Jul 15;2022:7698583. doi: 10.1155/2022/7698583. eCollection 2022.
- Background: PubMed 28506941Kiemeneij F. Left distal transradial access in the anatomical snuffbox for coronary angiography (ldTRA) and interventions (ldTRI). EuroIntervention. 2017 Sep 20;13(7):851-857. doi: 10.4244/EIJ-D-17-00079.
- Background: PubMed 34069701Lee OH, Roh JW, Im E, Cho DK, Jeong MH, Choi D, Kim Y. Feasibility and Safety of the Left Distal Radial Approach in Percutaneous Coronary Intervention for Bifurcation Lesions. J Clin Med. 2021 May 19;10(10):2204. doi: 10.3390/jcm10102204.
- Background: PubMed 34501468Klimek K, Swiatek M, Klocek K, Tworek M, Zwolski M, Milewski K, Janas A. Comparison of Safety and Efficiency between Tiger-2 Catheter with Right Radial Artery Access and Judkins Catheter with Left Radial Artery Access. J Clin Med. 2021 Sep 6;10(17):4020. doi: 10.3390/jcm10174020.
- Background: PubMed 19616324Burzotta F, Trani C, De Vita M, Crea F. A new operative classification of both anatomic vascular variants and physiopathologic conditions affecting transradial cardiovascular procedures. Int J Cardiol. 2010 Nov 5;145(1):120-2. doi: 10.1016/j.ijcard.2009.06.025. Epub 2009 Jul 17.
- Background: PubMed 19926044Dehghani P, Mohammad A, Bajaj R, Hong T, Suen CM, Sharieff W, Chisholm RJ, Kutryk MJ, Fam NP, Cheema AN. Mechanism and predictors of failed transradial approach for percutaneous coronary interventions. JACC Cardiovasc Interv. 2009 Nov;2(11):1057-64. doi: 10.1016/j.jcin.2009.07.014.
- Background: PubMed 32166728Kawamura Y, Yoshimachi F, Nakamura N, Yamamoto Y, Kudo T, Ikari Y. Impact of dedicated hemostasis device for distal radial arterial access with an adequate hemostasis protocol on radial arterial observation by ultrasound. Cardiovasc Interv Ther. 2021 Jan;36(1):104-110. doi: 10.1007/s12928-020-00656-4. Epub 2020 Mar 12.
- Background: PubMed 36335609Abdelazeem B, Abuelazm MT, Swed S, Gamal M, Atef M, Al-Zeftawy MA, Noori MA, Lutz A, Volgman AS. The efficacy of nitroglycerin to prevent radial artery spasm and occlusion during and after transradial catheterization: A systematic review and meta-analysis of randomized controlled trials. Clin Cardiol. 2022 Dec;45(12):1171-1183. doi: 10.1002/clc.23906. Epub 2022 Nov 6.
- Background: PubMed 35570688Kiemeneij F, Burzotta F, Fajadet J. Thirty years of transradial coronary interventions. EuroIntervention. 2022 May 15;18(1):19-21. doi: 10.4244/EIJ-E-22-00009. No abstract available.
- Background: PubMed 18908938RADNER S. Thoracal aortography by catheterization from the radial artery; preliminary report of a new technique. Acta Radiol (Stockh). 1948 Feb 28;29(2):178-80. doi: 10.3109/00016924809132437. No abstract available.
- Individual participant dataSharing planned: No
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Referral and contact
AzTrials does not enrol participants or take referrals. Contact the study team or a site listed below; they decide who can take part. This study is not recruiting at the moment.
The record lists no contact. Use the official record to reach the sponsor.
1 site in 1 country: see every site and its status.
Questions about this trial
What is this clinical trial studying?
An observational study of Coronary Artery Disease, run by Assiut University at 1 site in Egypt.
The full registered description is in the About this study section and the official record.
Who may be eligible to take part?
The sponsor lists 1 inclusion and 5 exclusion criteria. Eligibility is decided by the study team after screening, so read the full criteria and contact a listed site.
Is this clinical trial currently recruiting?
The record says: finished, as of the sponsor's last update on 4 Jun 2025. Status can change between updates, so confirm with the study contact before making plans.
Where is the study taking place?
The record lists 1 site in Egypt. Whether a site is taking part right now should be confirmed with that site. See every site.
What are the possible benefits and risks?
They depend on the study and the treatment, and no study can promise a benefit. The study team explains the known risks during informed consent, before anyone joins; the record itself does not list them.
Are results available for this study?
The study is completed, but results are not available in the source record. That does not mean the treatment did or did not work.
How can a doctor refer a patient or contact the research team?
The record lists no contact. The official record names the sponsor, who can be asked directly. AzTrials does not enrol participants or take referrals.
What does the primary outcome measure?
Comparison between right and left radial approach in patients undergoing percutaneous coronary Procedures , is there is difference in tortuosity of the radial and subclavian arteries between both approaches ? (time frame: Baseline). The study lists 4 primary outcomes in all. It is what the study was designed to measure, not a finding.
Where can I read the original study information?
On the ClinicalTrials.gov record for NCT05626660, which also lists 10 linked publications.
Does a listing mean the treatment is approved or proven to work?
No. A listing means the study is registered. It does not show that the treatment is safe, works, or is approved by a regulator.
How often is this information updated?
AzTrials copies changed records from ClinicalTrials.gov every night and reloads the whole registry every week. The sponsor last updated this record on 4 Jun 2025.