Transradial approach for coronary chronic total occlusion interventions: Insights from a contemporary multicenter registry

被引：61

作者：

Alaswad, Khaldoon ^{[1
]}

Menon, Rohan V. ^{[2
,3
]}

Christopoulos, Georgios ^{[2
,3
]}

Lombardi, William L. ^{[4
]}

Karmpaliotis, Dimitri ^{[5
]}

Grantham, J. Aaron ^{[6
,7
]}

Marso, Steven P. ^{[6
,7
]}

Wyman, Michael R. ^{[8
]}

Pokala, Nagendra R. ^{[2
,3
]}

Patel, Siddharth M. ^{[2
,3
]}

Kotsia, Anna P. ^{[2
,3
]}

Rangan, Bavana V. ^{[2
,3
]}

Lembo, Nicholas ^{[9
]}

Kandzari, David ^{[9
]}

Lee, James ^{[9
]}

Kalynych, Anna ^{[9
]}

Carlson, Harold ^{[9
]}

Garcia, Santiago A. ^{[10
,11
]}

Thompson, Craig A. ^{[12
]}

Banerjee, Subhash ^{[2
,3
]}

Brilakis, Emmanouil S. ^{[2
,3
]}

机构：

[1] Henry Ford Hosp, Detroit, MI 48202 USA

[2] VA North Texas Hlth Care Syst, Dallas, TX USA

[3] Univ Texas SW Med Ctr Dallas, Dallas, TX 75390 USA

[4] St Joseph Hosp, Bellingham, WA USA

[5] Piedmont Hosp, Atlanta, GA USA

[6] St Lukes Mid Amer Heart Inst, Kansas City, MO USA

[7] Univ Missouri, Kansas City, MO 64110 USA

[8] Torrance Mem Ctr, Los Angeles, CA USA

[9] Piedmont Hosp, Atlanta, GA USA

[10] Minneapolis VA Healthcare Syst, Minneapolis, MN USA

[11] Univ Minnesota, Minneapolis, MN USA

[12] Boston Sci, Natick, MA USA

来源：

CATHETERIZATION AND CARDIOVASCULAR INTERVENTIONS | 2015年 / 85卷 / 07期

基金：

美国国家卫生研究院;

关键词：

chronic total occlusion; percutaneous coronary intervention; radial access; FEMORAL ACCESS; ANGIOGRAPHY; SCORE;

D O I：

10.1002/ccd.25827

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

ObjectivesTo examine the impact of transradial access on the procedural outcomes of chronic total occlusion (CTO) percutaneous coronary interventions (PCI). BackgroundThe efficacy and safety of transradial access in CTO PCI has received limited study. MethodsWe 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. ResultsMost 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 (14283 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). ConclusionTransradial CTO PCI can be performed with similar success and complication rates with transfemoral CTO PCI, but is associated with longer procedural and fluoroscopy times. (c) 2015 Wiley Periodicals, Inc.

引用

页码：1123 / 1129

页数：7

共 20 条

[1] Comparison of transradial and femoral approaches for percutaneous coronary interventions: A systematic review and hierarchical Bayesian meta-analysis [J].