The Feasibility and Safety of Transradial Coronary Stenting Using 6 French Guiding Catheter

Cha, Kwang Soo; Kim, Moo Hyun; Kim, Hye Jin; Yang, Doo Kyung; Cho, Jeong Whan; Park, Tae Ho; Park, Hyung Ryul; Kim, Bong Keun; Kim, Young Dae; Kim, Jong Seong

Abstract

OBJECTIVES
Powerful anticoagulant and antiplatelet therapies after coronary stenting may carry the risk of increased bleeding complications if large-bore guiding catheters are introduced via the femoral artery. Recently smaller radial artery is introduced as an entry site for coronary interventions owing to miniaturization of equipments, easy hemostasis and lower access site complications, and little hand ischemia. The purpose of this study is to evaluate the feasibility and safety of coronary stent implantation via the radial artery.
METHODS
After a learning curve for transradial diagnostic coronary angiography, stent implantation was attempted in 131 consecutive patients, 135 lesions. Immediately after procedure, the introducer sheath was withdrawn and mobilization was initiated. Clinical follow-up was done for punctured radial arteries.
RESULTS
Procedural success and uncomplicated clinical course was achieved in 129(98%) patients, 133(99%) lesions. No stent embolization or migration within the coronary artery, and no procedure-related death, Q wave myocardial infarction or emergent bypass surgery were happened. No stroke or severe arm vessel complications were happened except 4(3%) cases of moderate hematoma. Failed 2 cases were in early period and stents did not pass the lesions due to inappropriate selection and poor backup of guiding catheters. During follow-up of 124+/-36 days, punctured radial arteries showed weak or absent radial pulse in 10(7%) patients, but no claudication or ischemia of hand was observed.
CONCLUSION
Transradial coronary stenting was performed safely with high success rate and low complication rate. This study supports that transradial approach is a promising primary route for coronary stenting.