Korean Circ J.  2003 Sep;33(9):805-812. 10.4070/kcj.2003.33.9.805.

The Experience of Transradial Coronary Intervention for Chronic Total Occlusion

• Kim JY
• Yoon J
• Jung HS
• Kim WJ
• Ahn MS
• Lee KH
• Yoo BS
• Lee SH
• Hwang SO
• Choe KH

• KMID: 2145626
• DOI: http://doi.org/10.4070/kcj.2003.33.9.805

Abstract

BACKGROUND AND OBJECTIVE
We try to evaluate the feasibility of transradial approach in patients with a chronic total occlusion.
SUBJECTS AND METHODS
Between Mar., 2000 and Oct., 2002, 52 consecutive patients, with 54 lesions, underwent transradial coronary intervention for a chronic total occlusion, which was defined as duration of an occlusion of more than 1 month. The patients were divided into the success or failure group, with the clinical, angiographic and procedural factors compared between the two groups.
RESULTS
The overall success rate of the transradial approach was 57.7% (31/54). The most common cause of failure of the transradial coronary intervention was an inability to pass the lesions using a guidewire (17 of 23 failures, 74%). Five cases were crossed over to the femoral artery due to an approach failure of the guiding catheter into the coronary ostium; severe subclavian tortuosity and stenosis in 2 cases, radial artery looping in 1 and poor guiding support in the other 2. A procedural success was more common in lesions with no side branch, no bridging collateral, short duration of occlusion and lesions less than 15mm in length. Non-Q wave myocardial infarction occurred in 1 case. There were no major entry site complications.
CONCLUSION
The radial artery might be a feasible vascular route in the percutaneous coronary intervention of chronic total occlusions with comparable procedural success rates and no major access site complications.

Keyword

Coronary diesease; Coronary angioplasty; Radial artery

MeSH Terms

Catheters
Constriction, Pathologic
Femoral Artery
Humans
Myocardial Infarction
Percutaneous Coronary Intervention
Radial Artery