TY - JOUR
T1 - Transradial approach for coronary chronic total occlusion interventions
T2 - Insights from a contemporary multicenter registry
AU - Alaswad, Khaldoon
AU - Menon, Rohan V.
AU - Christopoulos, Georgios
AU - Lombardi, William L.
AU - Karmpaliotis, Dimitri
AU - Grantham, J. Aaron
AU - Marso, Steven P.
AU - Wyman, Michael R.
AU - Pokala, Nagendra R.
AU - Patel, Siddharth M.
AU - Kotsia, Anna P.
AU - Rangan, Bavana V.
AU - Lembo, Nicholas
AU - Kandzari, David
AU - Lee, James
AU - Kalynych, Anna
AU - Carlson, Harold
AU - Garcia, Santiago A.
AU - Thompson, Craig A.
AU - Banerjee, Subhash
AU - Brilakis, Emmanouil S.
N1 - Publisher Copyright:
© 2015 Wiley Periodicals, Inc.
PY - 2015/6/1
Y1 - 2015/6/1
N2 - Objectives To examine the impact of transradial access on the procedural outcomes of chronic total occlusion (CTO) percutaneous coronary interventions (PCI). Background The efficacy and safety of transradial access in CTO PCI has received limited study. Methods We compared the technique and outcomes of transradial vs. transfemoral access among 650 CTO PCI cases performed between January 2012 and March 2014 at 6 US centers. Results Most patients were men (87%) with high frequency of diabetes mellitus (42%) and prior coronary artery bypass graft surgery (36%). The CTO target vessel was the right coronary (59%), left anterior descending (20%), or circumflex (17%) artery. TR access was used in 110 (17%) of the 650 cases, as follows: bilateral radial access (63%); bilateral radial access plus unilateral or bilateral femoral access (7%); unilateral radial access plus unilateral or bilateral femoral access (26%); and unilateral radial access (4%). Six and eight French guide catheters were used through the radial and femoral artery, respectively. Compared to transfemoral, transradial cases had similar technical (92.6% vs. 93.0%, P=0.87) and procedural (91.1% vs. 90.0%, P=0.95) success and major complication rates (1.7% vs 1.8%, P=0.99). However, transradial access was associated with higher mean procedure (142±83 vs. 120±60 min, P=0.008) and fluoroscopy (58±40 vs. 49±31 min, P <0.026) time, and number of crossing approach changes (0.7±1.0 vs. 0.5±0.7, P=0.008). Conclusion Transradial CTO PCI can be performed with similar success and complication rates with transfemoral CTO PCI, but is associated with longer procedural and fluoroscopy times.
AB - Objectives To examine the impact of transradial access on the procedural outcomes of chronic total occlusion (CTO) percutaneous coronary interventions (PCI). Background The efficacy and safety of transradial access in CTO PCI has received limited study. Methods We compared the technique and outcomes of transradial vs. transfemoral access among 650 CTO PCI cases performed between January 2012 and March 2014 at 6 US centers. Results Most patients were men (87%) with high frequency of diabetes mellitus (42%) and prior coronary artery bypass graft surgery (36%). The CTO target vessel was the right coronary (59%), left anterior descending (20%), or circumflex (17%) artery. TR access was used in 110 (17%) of the 650 cases, as follows: bilateral radial access (63%); bilateral radial access plus unilateral or bilateral femoral access (7%); unilateral radial access plus unilateral or bilateral femoral access (26%); and unilateral radial access (4%). Six and eight French guide catheters were used through the radial and femoral artery, respectively. Compared to transfemoral, transradial cases had similar technical (92.6% vs. 93.0%, P=0.87) and procedural (91.1% vs. 90.0%, P=0.95) success and major complication rates (1.7% vs 1.8%, P=0.99). However, transradial access was associated with higher mean procedure (142±83 vs. 120±60 min, P=0.008) and fluoroscopy (58±40 vs. 49±31 min, P <0.026) time, and number of crossing approach changes (0.7±1.0 vs. 0.5±0.7, P=0.008). Conclusion Transradial CTO PCI can be performed with similar success and complication rates with transfemoral CTO PCI, but is associated with longer procedural and fluoroscopy times.
KW - chronic total occlusion
KW - percutaneous coronary intervention
KW - radial access
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U2 - 10.1002/ccd.25827
DO - 10.1002/ccd.25827
M3 - Article
C2 - 25640902
AN - SCOPUS:84929710181
SN - 1522-1946
VL - 85
SP - 1123
EP - 1129
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 7
ER -