The feasibility of percutaneous transradial coronary intervention for chronic total occlusion.
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.
Kim
Jang-Young
JY
Division of Cardiology, Yonsei University, Wonju College of Medicine, 162 Ilsan-dong, Wonju 220-701, Korea.
Lee
Seung-Hwan
SH
Choe
Hyun-Min
HM
Yoo
Byung-Su
BS
Yoon
Junghan
J
Choe
Kyung-Hoon
KH
D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000379:methods*; D003327:Coronary Disease / Q000175:diagnosis / Q000628:therapy*; D005240:Feasibility Studies; D006801:Humans; D007431:Intraoperative Complications; D017534:Radial Artery / Q000601:surgery; D016896:Treatment Outcome