Comparison of immediate and followup results between transradial and transfemoral approach for percutaneous coronary intervention in true bifurcational lesions
- Author:
- No author available
- Journal Title:
- CHINESE MEDICAL JOURNAL
- Issue:
- 7
- DOI:
- No doi available
- Key Word:
- transradial percutaneous coronary intervention;transfemoral percutaneous coronary intervention;bifurcational lesions;treatment outcome
Abstract： Background A comparison of efficacy and safety between transradial and transfemoral approach for percutaneous coronary intervention (PCI) in bifurcations has not been done. This study evaluated feasibility of transradial PCI (TRI) and compared the immediate and followup results with transfemoral PCI (TFI) in bifurcations.Methods One hundred and thirty-four consecutive patients with bifurcations were treated with PCl in our hospital from April 2004 to October 2005. Of these, there were 60 patients (88 lesions) in TRI group and 74 patients (101 lesions) in TFI group. Bifurcations type was classified according to the Institut Cardiovasculaire Paris Sud Classification.Results TRI group had smaller stent diameter ((3.06±0.37) mm vs (3.18±0.35) mm, P=0.023) and postprocedural in-stent minimum lumen diameter ((2.62±0.37) mm vs (2.74±0.41) mm, P=0.029) than TFI, but there were not significant differences in in-stent subacute thrombosis rate (0% vs 1.0%, P=0.349), target lesion revascularization (TLR)(0% vs 1.0%, P=0.349) following procedure and thrombosis (2.3% vs 1.0%, P=0.482), in-stent restenosis (12.5% vs10.9%, P=0.731), in-segment restenosis (17.0% vs 14.9%, P=0.681), TLR (10.2% vs 13.9%, P=0.446) and TLR-free cumulative survival rate (89.8% vs 86.1%, P=0.787) at seven months followup. No death was reported in the two groups.Conclusion Transradial intervention is feasible and appears to be as effective and safe as transfemoral PCI in treatment of true bifurcational lesions.
- [1]Ferdinand Kiemeneij,Gert Jan Laarman,Diego Odekerken,etc.A Randomized Comparison of Percutaneous Transluminal Coronary Angioplasty by the Radial, Brachial and Femoral Approaches: The Access Study[J].1997,29(6).
- [2]Cox DA,Hermiller J,Turco M,etc.A polymer-based, paclitaxel-eluting stent in patients with coronary artery disease.[J].2004,350(3).
- [3]Abhaichand RK,Louvard Y,Gobeil JF,etc.The problem of arteria lusoria in right transradial coronary angiography and angioplasty.[J].2001,54(2).
- [4]Tift Mann,Gabriela Cubeddu,Josie Bowen,etc.Stenting in acute coronary syndromes: a comparison of radial versus femoral access sites[J].1998,32(3).
- [5]E, Benit,L, Missault,T, Eeman,etc.Brachial, radial, or femoral approach for elective Palmaz-Schatz stent implantation: a randomized comparison.[J].1997,41(2).
- [6]Dumas P,Premchand RK,Lefevre T,etc.Stenting of bifurcation lesions: classification, treatments, and results (see comments)[J].2000,49(3).
- [7]Ge L,Colombo A,Iakovou I.Contemporary stent treatment of coronary bifurcations.[J].2005,46(8).
- [8]Hoshino S,Isshiki T,Sato T,etc.Anatomic variations of the radial artery in patients undergoing transradial coronary intervention.[J].2000,49(4).
- [9]F, Kiemeneij,J, Hofland,G J, Laarman,etc.Cost comparison between two modes of Palmaz Schatz coronary stent implantation: transradial bare stent technique vs. transfemoral sheath-protected stent technique.[J].1995,35(4).
- [10]Dauerman,HL,Higgins,PJ,Sparano,AM,etc.Mechanical debulking versus balloon angioplasty for the treatment of true bifurcation lesions (see comments)[J].1998,32(7).
- [11]Lefevre T,Louvard Y,Morice M,etc.Coronary angiography through the radial or the femoral approach: The CARAFE study.[J].2001,52(2).
- [12]Dzavik V.Balloon crush: Treatment of bifurcation lesions using the crush stenting technique as adapted for transradial approach of percutaneous coronary intervention.[J].2004,63(4).
- [13]Cooper,CJ,El,Shiekh-RA,Cohen,DJ,etc.Effect of transradial access on quality of life and cost of cardiac catheterization: A randomized comparison (see comments)[J].1999,138(3 Pt 1).
- [14]D J, Hildick-Smith,P F, Ludman,M D, Lowe,etc.Comparison of radial versus brachial approaches for diagnostic coronary angiography when the femoral approach is contraindicated.[J].1998,81(6).