Coronary angiography and angioplasty are commonly performed through the radial artery. In some patients, anatomical variations of the radial and brachial arteries, such as loops, increased tortuosity or sharp angulations may pose challenges to equipment advancement.
Both the hydrophilic guidewire 0,035'' approach and the "Serpentine" technique have been described in the literature as techniques for overcoming radial anatomical challenges, with the hydrophilic guidewire approach being the more commonly used method.
In practical terms, both techniques involve the use of the same standard materials, with differences relating mainly to operator handling and technical manipulation. This study does not introduce any experimental device, material, or treatment; instead, it aims to compare the established approach using a 0.035'' hydrophilic guidewire with the emerging " Serpentine" technique with respect to effectiveness, procedural time, and safety.
Age ≥18 years
Feasibility of TRA
Indication for coronary angiography
Angiographic documentation of radial or brachial artery loop/tortuosity
STEMI - high risk NSTEMI presentation
Hemodynamic instability
Anatomical contraindications (e.g., arteriovenous fistula)
Significant calcification of the radial or brachial artery on angiographic evaluation.