Background Totally radial access(TRA) is getting popular in coronary chronic total occlusion(CTO) percutaneous coronary intervention(PCI). but it has been associated with a non-negligible risk of complications. Method...Background Totally radial access(TRA) is getting popular in coronary chronic total occlusion(CTO) percutaneous coronary intervention(PCI). but it has been associated with a non-negligible risk of complications. Methods This retrospective study included 1760 CTO patients underwent PCI from January 2015 to January 2018.Patients were divided into two groups: TRA group was referred to single radial or double radial access;Femoral access(FA) group was referred to single FA, double FA, FA and RA. The primary efficacy endpoint was procedural success, which was defined as technical success without in-hospital MACE. The primary safety endpoint was a composite of vascular complications and major bleeding. Results TRA was applied in 482 cases, while FA in 1278 cases. Mean J-CTO scores was higher in FA group(2.5±1.0 vs. 2.0±0.9, P=0.001). Procedural success showed no significant difference between both groups(82.9% vs. 83.6%, P=0.823). The primary safety endpoint was higher in FA group(11.4 vs. 4.1%, P<0.001). On multivariate analysis, FA approach was independently associated with the primary safety endpoint [odds ratio;(OR) 2.887, 95% confidence interval(CI) 1.759-4.739,P=0.001], after adjusting for age, diabetes, body mass index, prior CABG, and J-CTO score. Conclusions TRA for CTO PCI might be associated with lower incidence of a composite endpoint of vascular complications and major bleeding, while maintaining similarly high success rates.[S Chin J Cardiol 2019;20(4):211-216]展开更多
Objective: Percutaneous coronary intervention (PCI) via the radial artery access has more advantages than that of femoral artery access, while radial or (and) brachial artery have tendency to be spasmodic. We sought t...Objective: Percutaneous coronary intervention (PCI) via the radial artery access has more advantages than that of femoral artery access, while radial or (and) brachial artery have tendency to be spasmodic. We sought to investigate the effectiveness and safety of guiding catheter crossing over spasmodic radial or (and) brachial artery segments by the aid of PCI wire and balloon compared with traditional anti-spasmodic approach. Methods: The clinical data of 168 patients with coronary artery disease (CAD) (group A), whose PCI was performed via radial artery access with radial or (and) brachial artery spasm or (and) dissection and guiding catheter passing through spasmodic segments successfully by the aid of PCI guiding wire and balloon were analyzed retrospectively, simultaneously, the other 73 patients (group B) who used conventional approach to cross over the spasmodic radial or (and) brachial artery segments were treated as the control. The success rate, the time consumption and the complication were compared between the two groups. Findings: There was no significant difference in the spasmodic site between the two groups (all p value > 0.05). The success rate in group A was significantly higher than that in group B (168(100%) vs 28 (38.4%), p (4.2%) vs 14 (19.2%), p Conclusions: It is more effective and safer for guiding catheter crossing over spasmodic or (and) dissected radial or (and) brachial artery segments by the aid of PCI guiding wire and balloon than using the routine approach of administration of anti-spasm drugs for trans-radial PCI.展开更多
基金supported by the Science and Technology Innovation Project from Foshan,Guangdong(No.FS0AA-KJ218-1301-0010)
文摘Background Totally radial access(TRA) is getting popular in coronary chronic total occlusion(CTO) percutaneous coronary intervention(PCI). but it has been associated with a non-negligible risk of complications. Methods This retrospective study included 1760 CTO patients underwent PCI from January 2015 to January 2018.Patients were divided into two groups: TRA group was referred to single radial or double radial access;Femoral access(FA) group was referred to single FA, double FA, FA and RA. The primary efficacy endpoint was procedural success, which was defined as technical success without in-hospital MACE. The primary safety endpoint was a composite of vascular complications and major bleeding. Results TRA was applied in 482 cases, while FA in 1278 cases. Mean J-CTO scores was higher in FA group(2.5±1.0 vs. 2.0±0.9, P=0.001). Procedural success showed no significant difference between both groups(82.9% vs. 83.6%, P=0.823). The primary safety endpoint was higher in FA group(11.4 vs. 4.1%, P<0.001). On multivariate analysis, FA approach was independently associated with the primary safety endpoint [odds ratio;(OR) 2.887, 95% confidence interval(CI) 1.759-4.739,P=0.001], after adjusting for age, diabetes, body mass index, prior CABG, and J-CTO score. Conclusions TRA for CTO PCI might be associated with lower incidence of a composite endpoint of vascular complications and major bleeding, while maintaining similarly high success rates.[S Chin J Cardiol 2019;20(4):211-216]
文摘Objective: Percutaneous coronary intervention (PCI) via the radial artery access has more advantages than that of femoral artery access, while radial or (and) brachial artery have tendency to be spasmodic. We sought to investigate the effectiveness and safety of guiding catheter crossing over spasmodic radial or (and) brachial artery segments by the aid of PCI wire and balloon compared with traditional anti-spasmodic approach. Methods: The clinical data of 168 patients with coronary artery disease (CAD) (group A), whose PCI was performed via radial artery access with radial or (and) brachial artery spasm or (and) dissection and guiding catheter passing through spasmodic segments successfully by the aid of PCI guiding wire and balloon were analyzed retrospectively, simultaneously, the other 73 patients (group B) who used conventional approach to cross over the spasmodic radial or (and) brachial artery segments were treated as the control. The success rate, the time consumption and the complication were compared between the two groups. Findings: There was no significant difference in the spasmodic site between the two groups (all p value > 0.05). The success rate in group A was significantly higher than that in group B (168(100%) vs 28 (38.4%), p (4.2%) vs 14 (19.2%), p Conclusions: It is more effective and safer for guiding catheter crossing over spasmodic or (and) dissected radial or (and) brachial artery segments by the aid of PCI guiding wire and balloon than using the routine approach of administration of anti-spasm drugs for trans-radial PCI.
