Ntaka, Khulasande Liso Sifiso2025-03-062023-10Ntaka, Khulasande Liso Sifiso. (2023). Diagnostic Coronary Angiography Access In Johannesburg. [Masters dissertation, University of the Witwatersrand, Johannesburg]. WIReDSpace. https://hdl.handle.net/10539/44105https://hdl.handle.net/10539/44105A research report submitted in fulfillment of the requirements for the degree of Master of Medicine, to the Faculty of Health Sciences, School of Clinical Medicine, University of the Witwatersrand, Johannesburg, 2023Background: Contemporary interventional cardiology guidelines prefer radial over femoral artery access when performing diagnostic coronary angiograms (DCA). There is a paucity of data on the safety and efficacy of radial and femoral DCA in low-and-middle-income countries. Methods: We retrospectively reviewed inpatient medical records and DCA reports of patients referred for DCA and evaluated the safety and efficacy of the femoral versus radial artery access route. Results: There were 653 patients with a mean age of 58.2 ±12.6 years. Radial access was used in 318 (48.7%) patients. The median duration of the DCA was slightly longer with radial access and was 50 minutes (Interquartile range (IQR): 40–60), while the median procedural duration for femoral artery access was 45 minutes (IQR: 35–60) (P = 0.010). The median total radiation dose in the femoral artery access group was 3511 µGym2 (IQR: 2154–5821), and patients in the radial artery access group were exposed to a median radiation dose of 4011 µGym2 (IQR: 2298–6411) (P = 0.0661). A total of 639 (97.9%) DCA were performed without crossover, and 99.0% (95% CI: 97.2 – 99.8) of DCA performed via the radial artery did not require crossover to transfemoral access, and 96.1% (95% CI: 93.4 – 97.9) of the DCA done via the femoral artery did not require crossover to transradial access (P = 0.009). Conclusion: Almost half of all diagnostic angiograms were performed via the radial artery. Both radial and femoral artery access were equally safe and efficacious in patients with coronary artery disease.en©2023 University of the Witwatersrand, Johannesburg. All rights reserved. The copyright in this work vests in the University of the Witwatersrand, Johannesburg. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of University of the Witwatersrand, Johannesburg.Diagnostic coronary angiographyVascular accessRadial artery accessFemoral artery accessVascular complicationsRadiation exposureContrast mediaUCTDSDG-3: Good health and well-beingSDG-4: Quality educationDissertationUniversity of the Witwatersrand, Johannesburg