Background. To investigate whether the presence of arterial anomalies in upper limb arteries can influence the success rate of transradial coronary angiography. Methods. retrograde transarterial sheath injection was done in patients with transradial coronary angiography. Arterial anomalies in the upper limb are evaluated in these patients. There are ten brachial (5.4%), 7 radial (4/2%), 5 subclavian (3%), and 3 brachiocephalic arteries (1.8%). There also were 4 loops in ulnar artery (2.4%) and one in radial (0.6%). Except cannulation time ( ), there were associations between anomalies and other times ( ) and contrast volume used ( ). Anomalies did not have any effect on procedural success rate and just in one patient because of subclavian loop,procedure changed to femoral approach ( ). Discussion. Patients without upper extremities anomalies in comparison with patients with anomalies had significantly shorter periods for angiographic time, catheterization time, and fluoroscopic time. We recommend femoral catheterization instead of radial catheterization in patients with upper extremities anomalies. 1. Introduction Coronary angiography and interventions from the radial artery have gained popularity mainly because of a very low complication rate with immediate postprocedural sheath removal despite full heparinization and antiplatelet therapy [1]. The transradial approach (TRA) was also preferred by patients when compared to the transfemoral approach [2]. However, this approach has also some limitations, which include definite learning curve, procedural failure rate, and occasional patient discomfort caused by arterial spasm. These last two limitations are seen more frequently with radioulnar loops and extreme arterial tortuosity. Recently, dramatic reduction of pain and spasm has been described with the use of a hydrophilic-coated introducer sheath [3]. The transradial technique is, however, associated with a significant learning curve even for experienced femoral operators [4–6]. Although procedure failures can sometimes be due to radial artery anatomical variations, there are limited data describing such variations [7]. We undertook the establishment of the frequency of radial artery anomalies and their relation to procedure outcome in patients undergoing a first transradial coronary procedure. 2. Materials and Methods 2.1. Study Population This was a prospective study that was performed in Imam Hospital of Iran. A total of 164 consecutive patients undergoing their first transradial coronary procedure were recruited from May 2011 to December 2011. Only
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