TY - JOUR
T1 - The feasibility of percutaneous transradial coronary intervention for chronic total occlusion
AU - Kim, Jang Young
AU - Lee, Seung Hwan
AU - Choe, Hyun Min
AU - Yoo, Byung Su
AU - Yoon, Junghan
AU - Choe, Kyung Hoon
PY - 2006/10
Y1 - 2006/10
N2 - We evaluated the feasibility of the transradial coronary intervention (TRCI) in 85 consecutive patients with chronic local occlusion (CTO). Clinical, angiographic and procedural factors were compared between the success and failure groups. An overall success rate of 65.5% (57 of 87 iesions) was achieved with TRCI, and the most common cause of failure was an inability to pass the lesion with a guidewire. A multivariate analysis demonstrated that the most significant predictor of failure was the duration of occlusion (OR 1.064 per month, 95% CI 1.005 to 1.126, p-0.03). The procedural success rate improved with use of new-generation hydrophilic guidewires. The 6 Fr guiding catheters were used in the majority of the 70 cases (81%). Five cases were crossed over to a femoral artery approach due to engagement failure of the guiding catheter into the coronary ostium because of severe subclavian tortuosity and stenosis in two cases, radial artery looping in one case, and poor guiding support in two cases. There were no major entry site complications. In conclusion, the radial artery might be a feasible vascular route in coronary interventions for CTO, with comparable procedural success and no access site complications.
AB - We evaluated the feasibility of the transradial coronary intervention (TRCI) in 85 consecutive patients with chronic local occlusion (CTO). Clinical, angiographic and procedural factors were compared between the success and failure groups. An overall success rate of 65.5% (57 of 87 iesions) was achieved with TRCI, and the most common cause of failure was an inability to pass the lesion with a guidewire. A multivariate analysis demonstrated that the most significant predictor of failure was the duration of occlusion (OR 1.064 per month, 95% CI 1.005 to 1.126, p-0.03). The procedural success rate improved with use of new-generation hydrophilic guidewires. The 6 Fr guiding catheters were used in the majority of the 70 cases (81%). Five cases were crossed over to a femoral artery approach due to engagement failure of the guiding catheter into the coronary ostium because of severe subclavian tortuosity and stenosis in two cases, radial artery looping in one case, and poor guiding support in two cases. There were no major entry site complications. In conclusion, the radial artery might be a feasible vascular route in coronary interventions for CTO, with comparable procedural success and no access site complications.
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U2 - 10.3349/ymj.2006.47.5.680
DO - 10.3349/ymj.2006.47.5.680
M3 - Article
C2 - 17066512
AN - SCOPUS:33750709639
SN - 0513-5796
VL - 47
SP - 680
EP - 687
JO - Yonsei medical journal
JF - Yonsei medical journal
IS - 5
ER -