Trans-Radial versus Trans-Femoral Intervention for the Treatment of Coronary Bifurcations: Results from Coronary Bifurcation Stenting Registry.
10.3346/jkms.2013.28.3.388
- Author:
Seungmin CHUNG
1
;
Sung Ho HER
;
Pil Sang SONG
;
Young Bin SONG
;
Joo Yong HAHN
;
Jin Ho CHOI
;
Sang Hoon LEE
;
Yangsoo JANG
;
Jung Han YOON
;
Seung Jea TAHK
;
Seung Jung PARK
;
Seung Hyuk CHOI
;
Ki Bae SEUNG
;
Hyeon Cheol GWON
Author Information
1. Division of Cardiology, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea. sh1214.choi@samsung.com
- Publication Type:Original Article ; Comparative Study ; Controlled Clinical Trial ; Research Support, Non-U.S. Gov't
- Keywords:
Bifurcation;
Percutaneous Coronary Intervention;
Trans-Radial Approach
- MeSH:
Aged;
Angioplasty, Balloon, Coronary/adverse effects/*methods;
Coronary Angiography;
Coronary Stenosis/mortality/radiography/*therapy;
Coronary Vessels/radiography/surgery;
*Drug-Eluting Stents;
Female;
Follow-Up Studies;
Hemorrhage/etiology;
Humans;
Kaplan-Meier Estimate;
Male;
Middle Aged;
Myocardial Infarction/etiology;
Myocardial Revascularization;
Proportional Hazards Models;
Registries
- From:Journal of Korean Medical Science
2013;28(3):388-395
- CountryRepublic of Korea
- Language:English
-
Abstract:
Trans-radial (TR) approach is increasingly recognized as an alternative to the routine use of trans-femoral (TF) approach. However, there are limited data comparing the outcomes of these two approaches for the treatment of coronary bifurcation lesions. We evaluated outcomes of TR and TF percutaneous coronary interventions (PCI) in this complex lesion. Procedural outcomes and clinical events were compared in 1,668 patients who underwent PCI for non-left main bifurcation lesions, according to the vascular approach, either TR (n = 503) or TF (n = 1,165). The primary outcome was major adverse cardiac events (MACE), including cardiac death, myocardial infarction (MI), and target lesion revascularization (TLR) in all patients and in 424 propensity-score matched pairs of patients. There were no significant differences between TR and TF approaches for procedural success in the main vessel (99.6% vs 98.6%, P = 0.08) and side branches (62.6% vs 66.7%, P = 0.11). Over a mean follow-up of 22 months, cardiac death or MI (1.8% vs 2.2%, P = 0.45), TLR (4.0% vs 5.2%, P = 0.22), and MACE (5.2% vs 7.0%, P = 0.11) did not significantly differ between TR and TF groups, respectively. These results were consistent after propensity score-matched analysis. In conclusion, TR PCI is a feasible alternative approach to conventional TF approaches for bifurcation PCI (clinicaltrials.gov number: NCT00851526).
