Serpentine vs Traditional Hydrophilic Guidewire Tracking in Complex Radial Anatomy

NCT07707427 | Recruiting

• 1 other identifier: 397/7-10-2025
• Study Type: interventional
• Target: 204
• Locations: 1 country
• Sites: 1

Brief Summary

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.

Conditions

Transradial Access(TRA); Coronary Angiography (CAG); Percutaneous Coronary Intervention (PCI); Radial Artery Loop; Radial Artery Tortuosity; Serpentine Technique; Hydrophilic Guidewire; Complex Radial Anatomy; Vascular Complications; Coronary Catheterization

Keywords

Coronary catheterization; Transradial access(TRA); Coronary Angiography (CAG); Percutaneous Coronary Intervention (PCI); Radial artery loop; Radial artery tortuosity; Serpentine Technique; Hydrophilic Guidewire; Complex Radial Anatomy; Vascular Complications

Outcome Measures

Primary Outcomes (1)

• Successful crossing of anatomical obstacles and procedure completion

  Successful crossing of radial/brachial artery loops or tortuosity with completion of coronary angiography or PCI.

  During coronary angiography/PCI procedure, assessed up to 3 hours

Secondary Outcomes (10)

• Total procedure time

  During index procedure, assessed up to 3 hours.

• Fluoroscopy time

  During index procedure, assessed up to 3 hours.

• Radiation exposure

  During index procedure, assessed up to 3 hours.

• Contrast volume used

  During index procedure, assessed up to 3 hours.

• Success rate of loop access per technique

  During index procedure, assessed up to 3 hours.

Study Arms (2)

Serpentine Technique

EXPERIMENTAL

Participants will undergo transradial navigation of radial or brachial artery loops, tortuosity, or sharp angulation using the Serpentine catheter manipulation technique to facilitate coronary angiography or PCI.

Procedure: Serpentine Technique

Hydrophilic Technique

ACTIVE COMPARATOR

Participants will undergo transradial navigation of radial or brachial artery loops, tortuosity, or sharp angulation using a standard 0.035-inch hydrophilic guidewire to facilitate coronary angiography or PCI.

Procedure: Hydrophilic Technique

Interventions

Serpentine Technique PROCEDURE

Catheter-based navigation technique using controlled rotational catheter manipulation to cross radial or brachial artery loops, tortuosity, or sharp angulation during transradial coronary angiography or PCI.

Serpentine Technique

Hydrophilic Technique PROCEDURE

Navigation of radial or brachial artery loops, tortuosity, or sharp angulation using a 0.035-inch hydrophilic guidewire during transradial coronary angiography or PCI.

Hydrophilic Technique

Eligibility Criteria

• Age: 18 Years+
• Sex: all
• Healthy Volunteers: No
• Age Groups: Adult (18-64), Older Adult (65+)

You may qualify if:

• Age ≥18 years
• Feasibility of TRA
• Indication for coronary angiography
• Angiographic documentation of radial or brachial artery loop/tortuosity
• Written informed consent

You may not qualify if:

• STEMI - high risk NSTEMI presentation
• Hemodynamic instability
• Anatomical contraindications (e.g., arteriovenous fistula)
• Significant calcification of the radial or brachial artery on angiographic evaluation.

Sponsors & Collaborators

• University Hospital of Patras: lead

Study Sites (1)

University Hospital of Patras

Pátrai, 26504, Greece

RECRUITING

Related Publications (40)

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Study Officials

• Grigorios Tsigkas, MD, PhD

  University Hospital of Patras

  PRINCIPAL INVESTIGATOR

Central Study Contacts

Grigorios Tsigkas, MD, PhD

CONTACT

+306974466662; gregtsig@hotmail.com

Study Design

• Study Type: interventional
• Phase: not applicable
• Allocation: RANDOMIZED
• Masking: SINGLE
• Who Masked: OUTCOMES ASSESSOR
• Purpose: TREATMENT
• Intervention Model: PARALLEL
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Tsigkas Grigorios pHD,Assistant proffessor of Cardiology at University Hospital of Patras

Study Record Dates

• First Submitted: July 6, 2026
• First Posted: July 16, 2026
• Study Start: May 14, 2026
• Primary Completion (Estimated): May 1, 2029
• Study Completion (Estimated): November 1, 2029
• Last Updated: July 16, 2026

Record last verified: 2026-07

Data Sharing

• IPD Sharing: Will not share

Locations

GR (1)