Transradial intervention via large-bore guide catheters: a study of coronary bifurcation disease treatment using the crush technique

J Invasive Cardiol. 2013 Sep;25(9):455-9.

Abstract

Transradial access for coronary intervention significantly reduces vascular complications and may be associated with a reduced risk of major adverse cardiovascular events. However, the small caliber of the radial artery has been considered a limitation to performing complex coronary intervention. Fifty-three patients with true bifurcation disease, in whom a two-stent strategy was felt to be indicated, were scheduled to undergo crush stenting via the transradial approach. Procedural outcome was recorded and 6- and 18-month clinical follow-up was performed. Successful crush stenting via the radial artery was performed in 51/55 lesions (93%). Crush stenting was performed in 53 lesions overall and successful final kissing inflation was achieved in 51/53 (96%). There were no in-hospital or procedural complications. The overall rate of death, myocardial infarction, or target vessel revascularization was 9.8% at 18-month follow-up. Complex percutaneous coronary intervention requiring large-bore catheters can be performed successfully in a high proportion of patients via the transradial approach. Crush stenting, with a very high rate of final kissing inflation, was associated in this series with excellent procedural and medium-term outcomes.

MeSH terms

  • Adult
  • Aged
  • Coronary Angiography
  • Coronary Artery Disease / therapy*
  • Coronary Vessels / diagnostic imaging
  • Feasibility Studies
  • Female
  • Humans
  • Male
  • Middle Aged
  • Percutaneous Coronary Intervention / instrumentation
  • Percutaneous Coronary Intervention / methods*
  • Radial Artery*
  • Retrospective Studies
  • Stents*
  • Treatment Outcome
  • Vascular Access Devices / classification*