Feasibility and safety of coronary catheter rolling technique (Jahanzeb technique) for radial artery catheterization on arterial perforation and radial artery patency.

Abstract

Background: Transradial access is widely used for coronary angiography and percutaneous coronary intervention (PCI); however, complications such as radial artery spasm, perforation, and occlusion remain clinically relevant. Jahanzeb's Coronary Catheter Rolling Technique (JCRT) is a novel method designed to improve catheter navigation and reduce vascular trauma.

Objective: To evaluate the feasibility, safety and clinical outcomes of JCRT compared with the conventional radial catheterization technique.

Methods: In this prospective, non-randomized comparative study 4,697 patients undergoing elective coronary angiography or PCI via radial access were included. Patients were allocated to JCRT (n = 1,519) or the standard technique (n = 3,178). Primary endpoints were arterial perforation and radial artery occlusion. Secondary endpoints included major bleeding, radial artery spasm, thrombosis, and patient and physician satisfaction. Outcomes were analyzed using odds ratios (OR) with 95% confidence intervals (CI) and multivariable logistic regression was performed.

Results: JCRT was associated with a significantly lower overall complication rate (7.6% vs. 11.0%; OR: 0.66, 95% CI 0.52-0.92; p = 0.037). Significant reductions were observed in major bleeding (4.3% vs. 7.1%; OR: 0.58, 95% CI 0.42-0.81; p = 0.024), radial artery spasm (2.1% vs. 4.9%; OR: 0.41, 95% CI 0.27-0.63; p = 0.011), arterial perforation (1.6% vs. 3.8%; OR: 0.41, 95% CI 0.24-0.71; p = 0.032), and radial artery occlusion (2.8% vs. 6.3%; OR: 0.43, 95% CI 0.29-0.63; p = 0.006). On multivariable analysis, JCRT remained associated with reduced complications after adjustment (adjusted OR: 0.69, 95% CI: 0.51-0.93; p = 0.021). Patient and physician satisfaction scores were significantly higher with JCRT (p < 0.001).

Conclusion: JCRT is a feasible and safe technique associated with reduced vascular complications and improved satisfaction. Further multicenter randomized studies are warranted to confirm these findings.