Efficacy and Safety Analysis of the Interventional Treatment Through the Distal Transradial Access in Patients With Complex Coronary Lesions
10.3969/j.issn.1000-3614.2024.08.006
- VernacularTitle:经远端桡动脉入路在复杂冠状动脉病变患者中行介入治疗的有效性和安全性分析
- Author:
Wei YU
1
,
2
;
Cheng CUI
;
Minghao LIU
;
Ying SONG
;
Tongqiang ZOU
;
Jue CHEN
;
Haibo LIU
;
Lei SONG
;
Zhan GAO
;
Huanhuan WANG
;
Lijian GAO
Author Information
1. 中国医学科学院 北京协和医学院 国家心血管病中心 阜外医院 冠心病中心,北京 100037
2. 秦皇岛市第三医院 心内科,秦皇岛 066000
- Keywords:
distal transradial access;
percutaneous coronary intervention;
complex lesions
- From:
Chinese Circulation Journal
2024;39(8):775-780
- CountryChina
- Language:Chinese
-
Abstract:
Objectives:Present study analyzed the efficacy and safety of percutaneous coronary intervention(PCI)using the distal transradial access(dTRA)for patients with complex coronary lesions. Methods:A total of 10 033 patients with complex coronary artery lesions(type B2 and type C lesions)who underwent percutaneous coronary intervention(PCI)via dTRA or conventional transradial access(TRA)at Fuwai Hospital between June 2021 and May 2022 were included(9 625 patients in the TRA group and 408 patients in the dTRA group).After propensity score matching,391 patients were included in each group.Baseline data,PCI intraoperative data(including lesion characteristics,intervention success rate,etc.),and incidence of major bleeding related to the access were compared between the two groups before and after propensity score matching. Results:Before propensity score matching,the proportions of patients with hypertension,hyperlipidemia,family history of coronary heart disease,history of myocardial infarction,and history of coronary artery bypass grafting were significantly higher in the dTRA group than in the TRA group(all P<0.05).After propensity score matching,the baseline data of the two groups were similar(all P>0.05).Before propensity score matching,compared with the TRA group,patients in the dTRA group had a higher proportion of patients with type B2 lesions,while the proportions of patients with type C lesions and those using intravascular ultrasound(IVUS)were lower(all P<0.05).The proportion of patients with chronic complete occlusion was similar between the two groups(P>0.05).After propensity score matching,compared with the TRA group,patients in the dTRA group had a lower proportion using IVUS and had a higher percent of stent implantation(both P<0.05).There was no statistically significant difference between the two groups in terms of SYNTAX score,guide catheter size,target lesion distribution,proportion of patients using intra-aortic balloon counterpulsation,success rate of intervention procedures,and incidence of major bleeding events related to the access(all P>0.05). Conclusions:Compared with the conventional TRA,interventional treatment of complex lesions through dTRA is equally safe and effective for patients with complex coronary lesions.
