AI Summary & Key Takeaways
AI InsightNo death was registered.Conclusion: The radial approach in CTO PCI was as fast and successful as the femoral approach, even in a complex lesion subset.
📌 3 Key Takeaways
Özet
Objective: There is limited data on the efficacy and the safety of the transradial approach (TRA) for percutaneous coronary intervention (PCI) ofchronic total occlusion (CTO), particularly in comparison with the transfemoral approach (TFA) in lesions with similar complexity.Methods: We included 358 patients, who underwent elective CTO PCI between January 2012 and August 2017 and compared the radial (179patients) and femoral (179 patients) approaches. The J-CTO score was similar in both groups (TRA, 2.5±1.3 vs. TFA, 2.8±1.4, n.s.). The endpointsanalyzed included (i) the composite of all-cause death and nonfatal myocardial infarction (MI) and (ii) the composite safety endpoint of majoradverse cardiovascular and cerebrovascular events (MACCEs), including death, MI, coronary perforation, contrast-induced nephropathy (CIN),bleeding at the vascular access site requiring transfusion, cardiac tamponade requiring pericardiocentesis, and periprocedural stroke.Results: Patients’ demographics, lesion location, lesion characteristics, and the proportion of antegrade vs. retrograde approach were similarin both groups. The procedural success rate of 96.4% in the radial group and 92.9% in the femoral group was comparable. The total fluoroscopytime (TRA, 42.4±15.7 min vs. TFA, 40.5±15.3 min, n.s.) and contrast medium use (TRA, 532.2±21.7 mL vs. TFA, 528.2±24.6 mL, n.s.) was similar in bothgroups. There was no in-hospital death or periprocedural MI in both groups. There were three coronary perforations in the TFA group, amongthem one with tamponade, and one coronary perforation the TRA group. Vascular access site complications (TRA, 0.01% vs. TFA, 0.02%) andCIN (TRA, 0.006% vs. TFA, 0.006%) were rare. One stroke as a result of the procedure was observed in the TFA group. No death was registered.Conclusion: The radial approach in CTO PCI was as fast and successful as the femoral approach, even in a complex lesion subset.