TY - JOUR
T1 - Distal Radial Access in Chronic Total Occlusion Percutaneous Coronary Intervention
T2 - Insights From the PROGRESS-CTO Registry
AU - Nikolakopoulos, Ilias
AU - Patel, Taral
AU - Jefferson, Brian K.
AU - Sheikh, Abdul M.
AU - Jaber, Wissam
AU - Samady, Habib
AU - Khatri, Jaikirshan J.
AU - Yeh, Robert W.
AU - Tamez, Hector
AU - Koutouzis, Michalis
AU - Tsiafoutis, Ioannis
AU - Jaffer, Farouc A.
AU - Doing, Anthony H.
AU - Dattilo, Phil
AU - Uretsky, Barry F.
AU - Toma, Catalin
AU - Elbarouni, Basem
AU - Alaswad, Khaldoon
AU - Choi, James W.
AU - Lembo, Nicholas J.
AU - Parikh, Manish
AU - Kirtane, Ajay J.
AU - Ali, Ziad A.
AU - Omer, Mohamed
AU - Vemmou, Evangelia
AU - Xenogiannis, Iosif
AU - Karacsonyi, Judit
AU - Rangan, Bavana V.
AU - Abdullah, Shuaib
AU - Banerjee, Subhash
AU - Garcia, Santiago
AU - Burke, M. Nicholas
AU - Brilakis, Emmanouil S.
AU - Karmpaliotis, Dimitri
PY - 2021/9/1
Y1 - 2021/9/1
N2 - BACKGROUND: The outcomes of distal radial access (dRA) in chronic total occlusion percutaneous coronary intervention (CTO-PCI) have received limited study. METHODS: We compared the clinical, angiographic, and procedural characteristics of 120 CTO-PCIs performed via dRA access with 2625 CTO-PCIs performed via proximal radial access (pRA) in a large, multicenter registry. RESULTS: The dRA group had lower mean PROGRESS-CTO score than the pRA group (1.0 ± 1 vs 1.2 ± 1, respectively; P=.05), while J-CTO score (2.4 ± 1.2 vs 2.3 ± 1.3; P=.43) and PROGRESS-CTO Complications score (2.8 ± 1.8 vs 2.6 ± 1.9; P=.16) were similar in the dRA vs pRA groups, respectively. Technical success was similar in the 2 groups (90% dRA vs 86% pRA; P=.14). Concomitant use of femoral access did not alter procedural success. The incidence of major periprocedural adverse cardiac events was similar in the 2 groups (0.8% dRA vs 2.4% pRA; P=.26), whereas the incidence of tamponade requiring pericardiocentesis was lower with dRA (0% dRA vs 4.69% pRA; P<.001), as was air kerma radiation dose (median, 1.7 Gy; interquartile range [IQR], 0.97-2.63 Gy in the dRA group vs median, 2.27 Gy; IQR, 1.2-3.9 Gy in the pRA group; P<.001). CONCLUSIONS: Use of dRA in CTO-PCI is associated with similar procedural success and risk of complications as compared with pRA.
AB - BACKGROUND: The outcomes of distal radial access (dRA) in chronic total occlusion percutaneous coronary intervention (CTO-PCI) have received limited study. METHODS: We compared the clinical, angiographic, and procedural characteristics of 120 CTO-PCIs performed via dRA access with 2625 CTO-PCIs performed via proximal radial access (pRA) in a large, multicenter registry. RESULTS: The dRA group had lower mean PROGRESS-CTO score than the pRA group (1.0 ± 1 vs 1.2 ± 1, respectively; P=.05), while J-CTO score (2.4 ± 1.2 vs 2.3 ± 1.3; P=.43) and PROGRESS-CTO Complications score (2.8 ± 1.8 vs 2.6 ± 1.9; P=.16) were similar in the dRA vs pRA groups, respectively. Technical success was similar in the 2 groups (90% dRA vs 86% pRA; P=.14). Concomitant use of femoral access did not alter procedural success. The incidence of major periprocedural adverse cardiac events was similar in the 2 groups (0.8% dRA vs 2.4% pRA; P=.26), whereas the incidence of tamponade requiring pericardiocentesis was lower with dRA (0% dRA vs 4.69% pRA; P<.001), as was air kerma radiation dose (median, 1.7 Gy; interquartile range [IQR], 0.97-2.63 Gy in the dRA group vs median, 2.27 Gy; IQR, 1.2-3.9 Gy in the pRA group; P<.001). CONCLUSIONS: Use of dRA in CTO-PCI is associated with similar procedural success and risk of complications as compared with pRA.
KW - coronary occlusion
KW - percutaneous coronary intervention
KW - radial artery
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M3 - Article
C2 - 34433693
AN - SCOPUS:85117623115
SN - 1042-3931
VL - 33
SP - E717-E722
JO - The Journal of invasive cardiology
JF - The Journal of invasive cardiology
IS - 9
ER -