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Cardiovascular

Randomized Comparison of Judkins and Tiger Catheters for Transradial Catheterization

Samir B. Pancholy, MD, FACC, FSCAI

 
Universal catheters for coronary angiography have several logical advantages. The Optitorque™ Catheter with a Tiger tip shape (“Tiger catheter,” Terumo Interventional Systems, Somerset, New Jersey) has been used to perform transradial coronary angiography via the right radial approach. The author randomized 90 consecutive patients referred for cardiac catheterization into 3 groups: transradial using Tiger catheters (Group 1), transradial using Judkins catheters (Group 2), and transfemoral using Judkins catheters (Group 3). Demographics were essentially comparable between the 3 groups. Group 1 had significantly lower fluoroscopy time compared to Group 2 (2.6 ± 1.3 minutes for Group 1, 3.6 ± 1.8 minutes, P < .05) making it comparable to transfemoral procedures (2.4 ± 1.5 minutes, P > .05). Procedure time was also shorter for Group 1 compared to Group 2 (10.2 ± 4.3 minutes for Group 1, 12.6 ± 3.1 minutes, P < .05). Angiographic quality was equivalent among the 3 groups. Judkins catheters typically were dependent on coaxial engagement for providing good quality angiograms. Tiger catheters, which frequently were engaging the coronary artery non-coaxially, provided good quality angiograms even with non-coaxial engagement, due to contrast exit from the side hole. Left ventriculography was more frequently associated with ventricular ectopy with the Tiger catheter compared to the right Judkins catheter, although provided equivalent angiographic quality. In conclusion, Tiger catheters perform comparably to Judkins catheters, providing excellent angiographic quality, with the capacity to opacify the coronary tree without the necessity for coaxial engagement. Tiger catheters also significantly decrease fluoroscopic exposure and procedure time.

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