Yonsei Med J.  2006 Oct;47(5):680-687. 10.3349/ymj.2006.47.5.680.

The Feasibility of Percutaneous Transradial Coronary Intervention for Chronic Total Occlusion

• Kim JY
• Lee SH
• Choe HM
• Yoo BS
• Yoon J
• Choe KH

• KMID: 1381249
• DOI: http://doi.org/10.3349/ymj.2006.47.5.680

Abstract

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.

Keyword

Coronary angioplasty; total occulusion; radial access

MeSH Terms

Treatment Outcome
Radial Artery/surgery
Intraoperative Complications
Humans
Feasibility Studies
Coronary Disease/diagnosis/*therapy
Angioplasty, Transluminal, Percutaneous Coronary/adverse effects/*methods

Figure

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  Fig. 1 Kinds of guiding catheters used in a radial approach among 87 chronic total occlusions. AL, Amplatz left; LCA, left coronary artery; RCA, right coronary artery.

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