title: Transradial intervention via large-bore guide catheters: a study of coronary bifurcation disease treatment using the crush technique.
abstract: Transradial access for coronary intervention significantly reduces vascular complications and may be associated with a reduced risk of major adverse cardiovascular events. However, the small caliber of the radial artery has been considered a limitation to performing complex coronary intervention. Fifty-three patients with true bifurcation disease, in whom a two-stent strategy was felt to be indicated, were scheduled to undergo crush stenting via the transradial approach. Procedural outcome was recorded and 6- and 18-month clinical follow-up was performed. Successful crush stenting via the radial artery was performed in 51/55 lesions (93%). Crush stenting was performed in 53 lesions overall and successful final kissing inflation was achieved in 51/53 (96%). There were no in-hospital or procedural complications. The overall rate of death, myocardial infarction, or target vessel revascularization was 9.8% at 18-month follow-up. Complex percutaneous coronary intervention requiring large-bore catheters can be performed successfully in a high proportion of patients via the transradial approach. Crush stenting, with a very high rate of final kissing inflation, was associated in this series with excellent procedural and medium-term outcomes.
authors.affiliation: St Vincent’s Hospital, Melbourne, VIC 3065, Australia. dr.pdwilliams@gmail.com
authors.forename: Paul D
authors.initials: PD
authors.lastname: Williams
authors.forename: Jonas
authors.initials: J
authors.lastname: Eichhöfer
authors.forename: Mamas A
authors.initials: MA
authors.lastname: Mamas
authors.forename: Samer
authors.initials: S
authors.lastname: Arnous
authors.forename: Farzin
authors.initials: F
authors.lastname: Fath-Ordoubadi
authors.forename: Douglas
authors.initials: D
authors.lastname: Fraser
mesh_terms: D000328:Adult; D000368:Aged; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000628:therapy*; D003331:Coronary Vessels / Q000000981:diagnostic imaging; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation / Q000379:methods*; D017534:Radial Artery; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome; D062666:Vascular Access Devices / Q000145:classification*