title: High-speed rotational atherectomy using the radial artery approach and a sheathless guide: a single-centre comparison with the "conventional" femoral approach.
abstract: This study retrospectively compares the in-hospital outcomes for patients undergoing high-speed rotational atherectomy (HSRA) facilitated percutaneous coronary intervention (PCI) using either the radial or the femoral artery approach. From September 2008 to February 2013, 135 consecutive patients (75 femoral, 60 radial) underwent HSRA in our centre. A comparison of in-hospital outcomes was performed. For the radial approach, a 7.5 Fr sheathless guiding catheter (SGC) was used. The sizing of the burrs deployed was similar (1.75 [0.75-2.00] vs. 1.75 [1.25-2.5] mm, p=0.68) with no difference in screening time (15.5 [12.2-19.5] vs. 19 [14-26] min, p=0.068), major access-site bleeding complications (0.0% vs. 1.3%, p>0.99) and procedural success (100% vs. 91%, p=0.22) in the radial and the femoral group, respectively. However, in-hospital stay [1 (0-5) vs. 1 (0-20) days, p=0.04] was slightly higher following the femoral approach. A temporary wire was placed in 10% of femoral patients. No in-hospital death was observed. This study shows that the radial artery approach with the 7.5 Fr SGC is at least as safe and effective as the conventional femoral approach for performing HSRA-facilitated PCI.
authors.affiliation: Oxford Heart Centre, John Radcliffe Hospital, Oxford, United Kingdom.
authors.forename: George
authors.initials: G
authors.lastname: Kassimis
authors.forename: Niket
authors.initials: N
authors.lastname: Patel
authors.forename: Rajesh K
authors.initials: RK
authors.lastname: Kharbanda
authors.forename: Keith M
authors.initials: KM
authors.lastname: Channon
authors.forename: Adrian P
authors.initials: AP
authors.lastname: Banning
mesh_terms: D000368:Aged; D017225:Atherectomy, Coronary / Q000295:instrumentation* / Q000379:methods*; D057785:Catheters; D005260:Female; D005263:Femoral Artery; D006801:Humans; D007902:Length of Stay / Q000706:statistics & numerical data; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000379:methods; D017534:Radial Artery; D012189:Retrospective Studies