Feasibility and safety of transradial stenting for unprotected left main coronary artery stenoses.
BACKGROUND
Percutaneous coronary intervention (PCI) is considered an excellent alternative treatment for unprotected left main coronary artery (ULMCA) stenoses. Most PCIs for ULMCA stenoses are performed via the transfemoral approach. The feasibility and safety of the transradial approach for this particular entity are unknown. The present study assessed the feasibility, safety and 1-year outcomes of the transradial approach for stenting of ULMCA stenoses.


RESULTS
Of 131 consecutive patients who underwent coronary stenting for ULMCA stenoses, 113 patients (86.3%) received stenting using the transradial approach. All 113 procedures were performed with 6 or 7 French (Fr) catheters except 1 procedure requiring an 8 Fr guiding catheter for directional atherectomy. The technical success rate was 100%, and angiographic success was achieved in 96 patients (85.9%). Two patients had local hematoma (1.8%), and no procedure-related deaths, Q-wave myocardial infarction, repetitive PCI, stroke or emergent coronary artery bypass graft surgery during hospitalization were noted. One (0.9%) in-hospital cardiac death occurred due to ventricular tachyarrhythmia. More than half of our patients stayed in hospital by < or =3 days. The 1-year target lesion revascularization and cardiac death rate were 14.2% and 3.5%, respectively.


CONCLUSIONS
This investigation demonstrated the feasibility, safety and accepted short-term clinical outcomes of transradial stenting for ULMCA stenosis. This procedure may offer a feasible alternative to the transfemoral approach.
Cheng
Cheng-I
CI
Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Chang Gung Memorial Hospital-Kaohsiung Medical Center, No.123 Ta-Pei Road, Niao-Sung Township, Kaohsiung County, 83301 Taiwan, ROC.
Wu
Chiung-Jen
CJ
Fang
Chih-Yuan
CY
Youssef
Ali A
AA
Chen
Chien-Jen
CJ
Chen
Shyh-Ming
SM
Yang
Cheng-Hsu
CH
Hsueh
Shu-Kai
SK
Yip
Hon-Kan
HK
Chen
Mien-Cheng
MC
Fu
Morgan
M
Hsieh
Yuan-Kai
YK
D000368:Aged; D000800:Angioplasty, Balloon / Q000009:adverse effects; D023921:Coronary Stenosis / Q000150:complications / Q000401:mortality / Q000628:therapy*; D003331:Coronary Vessels; D003643:Death; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality; D015607:Stents; D020521:Stroke / Q000209:etiology / Q000401:mortality; D015996:Survival Rate