Transradial approach for coronary chronic total occlusion interventions: Insights from a contemporary multicenter registry. Issue 7 (3rd February 2015)

• Record Type: Journal Article
• Authors: Alaswad, Khaldoon; Menon, Rohan V.; Christopoulos, Georgios; Lombardi, William L.; Karmpaliotis, Dimitri; Grantham, J. Aaron; Marso, Steven P.; Wyman, Michael R.; Pokala, Nagendra R.; Patel, Siddharth M.; Kotsia, Anna P.; Rangan, Bavana V.; Lembo, Nicholas; Kandzari, David; Lee, James; Kalynych, Anna; Carlson, Harold; Garcia, Santiago A.; Thompson, Craig A.; Banerjee, Subhash; Brilakis, Emmanouil S.
• Is Part Of: Catheterization and cardiovascular interventions. Volume 85:Issue 7(2015:Jun. 01)
• Page Start: 1123
• Page End: 1129
• Publication Date: 2015-02-03
• Subjects: Heart -- Diseases -- Diagnosis -- Periodicals; Cardiac catheterization -- Periodicals; 616.1207572
• DOI: 10.1002/ccd.25827
• Languages: English
• ISSNs: 1522-1946

Abstract

<abstract abstract-type="main"> <title> <x xml:space="preserve">Abstract</x> </title> <sec id="ccd25827-sec-0001" sec-type="section"> <title>Objectives</title> <p>To examine the impact of transradial access on the procedural outcomes of chronic total occlusion (CTO) percutaneous coronary interventions (PCI).</p> </sec> <sec id="ccd25827-sec-0002" sec-type="section"> <title>Background</title> <p>The efficacy and safety of transradial access in CTO PCI has received limited study.</p> </sec> <sec id="ccd25827-sec-0003" sec-type="section"> <title>Methods</title> <p>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.</p> </sec> <sec id="ccd25827-sec-0004" sec-type="section"> <title>Results</title> <p>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%, <italic>P</italic> = 0.87) and procedural (91.1% vs. 90.0%, <italic>P</italic> = 0.95) success and major complication rates (1.7% vs 1.8%, <italic>P</italic> = 0.99). However, transradial access was associated with higher mean procedure (142 ± 83 vs. 120 ± 60 min, <italic>P</italic> = 0.008) and fluoroscopy (58 ± 40 vs. 49 ± 31 min, <italic>P</italic> <0.026) time, and number of crossing approach changes (0.7 ± 1.0 vs. 0.5 ± 0.7, <italic>P</italic> = 0.008).</p> </sec> <sec id="ccd25827-sec-0005" sec-type="section"> <title>Conclusion</title> <p>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. © 2015 Wiley Periodicals, Inc.</p> </sec> </abstract>