070 A comparison of the success rates of transradial and transfemoral approaches for percutaneous coronary intervention of chronic total occlusions

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• 作者：Anouska Moynagh¹ ; Hakim Benamer¹ ; Yves Louvard¹ ; Marie-Claude Morice¹ ; Philippe Garot¹ ; Thomas Hovasse¹ ; Thierry Unterseeh² ; Bernard Chevalier¹ ; Oscar Tavolaro³ ; Thierry Lefè ; vre¹
• 刊名：Archives of Cardiovascular Diseases Supplements
• 出版年：2011
• 出版时间：January 2011
• 年：2011
• 卷：3
• 期：1
• 页码：22-23
• 全文大小：70 K

文摘

Purpose

Chronic total occlusions (CTOs) are found in approximately 30 % of Pts with coronary artery disease and represent the most difficult group for treatment by percutaneous coronary intervention (PCI) with a lower angiographic success rate. Transradial PCI is safe and effective, though the efficacy of this approach in CTOs has not been well studied.

Methods

All Pts treated with PCI for CTOs between Jan 2004 and Dec 2009 were retrospectively identified from a dedicated database. We compared the success rates via the transradial (TRA) and transfemoral approach (TFA) with attention to the lesion characteristics and techniques applied.

Results

979 Pts (63.2 ¡À 11.6 years, 87.3 % male) were studied. Baseline demographics and angiographic characteristics were similar between groups with no difference in lesion length, calcification or proximal vessel tortuosity. There was a significant difference in the rate of bifurcations performed via the TRA and TFA (29.1 % vs. 14.6 % , p<0.0001). Parallel wire technique and retrograde recanalisation were used more frequently from the TFA. TRA was associated with an increased use of anchoring balloons.

Sheath sizes > 6 French were used in 20/979(2 % ). Larger sheath size was associated with a higher rate of parallel wire technique (p = 0.0004), retrograde recanalisation (p<0.0001) and tornus use (p = 0.027).

Conclusions

	TFA (233 patients) TRA (646 patients) P value
Sheath size ?6F	218 (93.6 % )	642 (99.4 % )	<0.0001
Sheath size ?8F	11 (4.7 % )	0 (0)	<0.0001
Parallel wire	54 (23.2 % )	106 (16.4 % )	0.029
Side branch technique	7 (3.0 % )	41 (6.3 % )	0.06
Anchoring balloon	7 (3.0 % )	48 (7.4 % )	0.017
Retrograde recanalisation	16 (6.9 % )	18 (2.8 % )	0.009
Procedural time	73.4 +/?1.2min	80.7+/?0.7min	0.03
Contrast use	238.7mls +/?80.2mls	286.2 +/?57.3mls	0.001
Angiographic Success	139 (67.8 % )	441 (70.7 % )	0.44