title: The utility of a 5-in-6 double catheter technique in treating complex coronary lesions via transradial approach: the DOCA-TRI study.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of a 5-in-6 double catheter (DC) technique during transradial complex PCI compared to a conventional buddy-wire or balloon-anchoring approach.
  
  
  RESULTS
  One hundred and eighty-seven patients who failed in stent or balloon delivery after successful wiring of the target vessel were prospectively randomised to further treatment with a 5-in-6 DC technique (DC group, n=94) or by a conventional buddy-wire or balloon-anchoring approach (control group, n=93). Baseline clinical and lesion features were comparable between the two groups. The primary endpoint of technical success was significantly higher in the DC than in the control group (97.9% and 39.8%, p<0.001). Fifty-six patients (60.2%) in the control group with failure of the buddy-wire or balloon-anchoring approach achieved successful PCI with bailout use of a DC technique. Procedural x-ray time (58.2±23.1 min vs. 94.9±18.6 min, p<0.001), patient dose-area product (23,970±8,555 cGy.cm2 vs. 44,475±10,573 cGy.cm2, p<0.001) and contrast consumption (177±33 ml vs. 271±70 ml, p<0.001) were significantly reduced in the DC group. One-year major adverse cardiac event-free survival did not differ between the two groups (89.4% vs. 84.9%, p=0.36).
  
  
  CONCLUSIONS
  The use of a 5-in-6 DC technique, especially as a bailout strategy, is a more effective back-up support of the guiding system, subsequently facilitating the success of transradial PCI for complex coronary lesions, than a conventional buddy-wire or balloon-anchoring approach.
authors.affiliation: Department of Cardiology, Rui Jin Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200025, China.
authors.forename: Qi
authors.initials: Q
authors.lastname: Zhang
authors.forename: Rui Yan
authors.initials: RY
authors.lastname: Zhang
authors.forename: Ajay J
authors.initials: AJ
authors.lastname: Kirtane
authors.forename: Jian
authors.initials: J
authors.lastname: Hu
authors.forename: Zhen Kun
authors.initials: ZK
authors.lastname: Yang
authors.forename: Jian Sheng
authors.initials: JS
authors.lastname: Zhang
authors.forename: Feng Hua
authors.initials: FH
authors.lastname: Ding
authors.forename: Wei Feng
authors.initials: WF
authors.lastname: Shen
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation* / Q000401:mortality; D062906:Cardiac Catheters; D016009:Chi-Square Distribution; D002681:China; D003287:Contrast Media; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000401:mortality / Q000628:therapy*; D018572:Disease-Free Survival; D054855:Drug-Eluting Stents; D004867:Equipment Design; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D011446:Prospective Studies; D011474:Prosthesis Design; D017534:Radial Artery / Q000000981:diagnostic imaging; D011829:Radiation Dosage; D019233:Retreatment; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D003287:Contrast Media