TY - JOUR
T1 - Radial access for chronic total occlusion percutaneous coronary intervention
T2 - Insights from the PROGRESS-CTO registry
AU - PROGRESS-CTO Investigators
AU - Simsek, Bahadir
AU - Gorgulu, Sevket
AU - Kostantinis, Spyridon
AU - Karacsonyi, Judit
AU - Alaswad, Khaldoon
AU - Jaffer, Farouc A.
AU - Doshi, Darshan
AU - Goktekin, Omer
AU - Kerrigan, Jimmy
AU - Haddad, Elias
AU - Patel, Mitul
AU - Rinfret, Stephane
AU - Jaber, Wissam A.
AU - Nicholson, William
AU - Abi Rafeh, Nidal
AU - Allana, Salman
AU - Koutouzis, Michalis
AU - Brilakis, Emmanouil S.
N1 - Funding Information:
The authors are grateful for the philanthropic support of our generous anonymous donors, and the philanthropic support of Drs. Mary Ann and Donald A Sens; Mrs. Diane and Dr. Cline Hickok; Mrs. Wilma and Mr. Dale Johnson; Mrs. Charlotte and Mr. Jerry Golinvaux Family Fund; the Roehl Family Foundation; the Joseph Durda Foundation. The generous gifts of these donors to the Minneapolis Heart Institute Foundation's Science Center for Coronary Artery Disease (CCAD) helped support this research project.
Funding Information:
The authors are grateful for the philanthropic support of our generous anonymous donors, and the philanthropic support of Drs. Mary Ann and Donald A Sens; Mrs. Diane and Dr. Cline Hickok; Mrs. Wilma and Mr. Dale Johnson; Mrs. Charlotte and Mr. Jerry Golinvaux Family Fund; the Roehl Family Foundation; the Joseph Durda Foundation. The generous gifts of these donors to the Minneapolis Heart Institute Foundation's Science Center for Coronary Artery Disease (CCAD) helped support this research project.
Publisher Copyright:
© 2022 Wiley Periodicals LLC.
PY - 2022/11/1
Y1 - 2022/11/1
N2 - Use of radial access for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has been increasing. We examined the clinical characteristics and procedural outcomes of patients who underwent CTO PCI with radial versus femoral access in the Prospective Global Registry for the Study of CTO Intervention (PROGRESS-CTO, NCT02061436). Of 10,954 patients who underwent CTO PCI at 55 centers in 7 countries between 2012 and 2022, 2578 (24%) had a radial only approach. Patients who underwent radial only access were younger (63 ± 10 vs. 65 ± 10, years, p < 0.001), more likely to be men (84% vs. 81%, p = 0.001), and had significantly lower prevalence of comorbidities compared with the femoral access group including diabetes mellitus (39% vs. 45%, p < 0.001) and coronary artery bypass graft surgery (57% vs. 64%, p < 0.001). In addition, radial only cases had lower angiographic complexity with lower J-CTO and PROGRESS-CTO scores. After adjusting for potential confounders, radial only access was associated with lower risk of access site complications (odds ratio [OR]: 0.45, 95% confidence interval [CI]: 0.22–0.91), similar technical success (OR: 0.87, 95% CI: 0.74–1.04) and major adverse cardiovascular events (MACE) (OR: 0.65, 95% CI: 0.40–1.07), compared with the femoral access group. Radial only access was used in 24% of CTO PCIs and was associated with lower access site complications, and similar technical success and MACE as compared with the femoral access group.
AB - Use of radial access for chronic total occlusion (CTO) percutaneous coronary intervention (PCI) has been increasing. We examined the clinical characteristics and procedural outcomes of patients who underwent CTO PCI with radial versus femoral access in the Prospective Global Registry for the Study of CTO Intervention (PROGRESS-CTO, NCT02061436). Of 10,954 patients who underwent CTO PCI at 55 centers in 7 countries between 2012 and 2022, 2578 (24%) had a radial only approach. Patients who underwent radial only access were younger (63 ± 10 vs. 65 ± 10, years, p < 0.001), more likely to be men (84% vs. 81%, p = 0.001), and had significantly lower prevalence of comorbidities compared with the femoral access group including diabetes mellitus (39% vs. 45%, p < 0.001) and coronary artery bypass graft surgery (57% vs. 64%, p < 0.001). In addition, radial only cases had lower angiographic complexity with lower J-CTO and PROGRESS-CTO scores. After adjusting for potential confounders, radial only access was associated with lower risk of access site complications (odds ratio [OR]: 0.45, 95% confidence interval [CI]: 0.22–0.91), similar technical success (OR: 0.87, 95% CI: 0.74–1.04) and major adverse cardiovascular events (MACE) (OR: 0.65, 95% CI: 0.40–1.07), compared with the femoral access group. Radial only access was used in 24% of CTO PCIs and was associated with lower access site complications, and similar technical success and MACE as compared with the femoral access group.
KW - chronic total occlusion
KW - complications
KW - femoral access
KW - percutaneous coronary intervention
KW - radial access
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U2 - 10.1002/ccd.30347
DO - 10.1002/ccd.30347
M3 - Article
C2 - 35870177
AN - SCOPUS:85135172256
SN - 1522-1946
VL - 100
SP - 730
EP - 736
JO - Catheterization and Cardiovascular Interventions
JF - Catheterization and Cardiovascular Interventions
IS - 5
ER -