Risk of brain injury during diagnostic coronary angiography: comparison between right and left radial approach.

Objectives: To assess the incidence of silent cerebral embolization when using the transradial approach for diagnostic coronary angiography (DCA).

Background: Compared to other vascular access sites, the right transradial approach (RTA) could reduce the amount of brain emboli by avoiding mechanical trauma to the aortic wall caused by catheters and wire, whereas it increases manipulation of catheters in the ascending aorta and has a higher risk of direct embolization into the right common carotid artery. A recent study showed an increased incidence of microembolic signals (MES) in RTA compared to femoral.