The Feasibility of Percutaneous Transradial Coronary Intervention for Chronic Total Occlusion.
10.3349/ymj.2006.47.5.680
- Author:
Jang Young KIM
1
;
Seung Hwan LEE
;
Hyun Min CHOE
;
Byung Su YOO
;
Junghan YOON
;
Kyung Hoon CHOE
Author Information
1. Department of Cardiology, Wonju College of Medicine, Yonsei University, Wonju, Korea. yoonj@wonju.yonsei.ac.kr
- Publication Type:Original Article ; Evaluation Studies
- Keywords:
Coronary angioplasty;
total occulusion;
radial access
- MeSH:
Treatment Outcome;
Radial Artery/surgery;
Intraoperative Complications;
Humans;
Feasibility Studies;
Coronary Disease/diagnosis/*therapy;
Angioplasty, Transluminal, Percutaneous Coronary/adverse effects/*methods
- From:Yonsei Medical Journal
2006;47(5):680-687
- CountryRepublic of Korea
- Language:English
-
Abstract:
We evaluated the feasibility of the transradial coronary intervention (TRCI) in 85 consecutive patients with chronic total 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 lesions) 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.
