Safety and feasibility of transradial coronary intervention in Chinese elderly patients

Objective To assess the feasibility and safety of transradial approach in Chinese elderly patients undergoing coronary intervention.Methods In this prospective study,764 elderly patients with coronary artery disease received percutaneous coronary intervention via either a transradial approach(TRA group)or a transfemoral approach(TFA group).The procedural success rate,success rate of artery access,puncture time,fluoroscopy time,dose of contrast,local complications and post-procedural pulmonary embolism were recorded and compared between 2 groups.Results There was no significant difference of the procedural success rate between the TRA group and the TRF group(96.3%vs.98.2%,P>0.05);there were also no differences of success rate of cannulation,mean fluoroscopy time and mean dose of contrast between the 2 groups.The mean puncture time was longer in the TRA group than in the TFA group(3.8±2.1 min vs.2.0±3.4 min,P<0.05).However,there were fewer access site-related complications in the TRA group than in the TFA group.Post-procedural pulmonary embolism occurred in 2 patients in the TFA group but none in the TRA group.Conclusion Transradial coronary intervention was feasible and safe in most Chinese elderly patients when performed by experienced operators.

Percutaneous coronary intervention following repair of type B aortic dissection:a report of 8 cases

Objective Patients with aortic dissection have a significant incidence of coronary artery disease.The purpose of this study is to evaluate the safety and feasibility of percutaneous coronary stent in patients who have undergone endovascular stent,and to assess the effect of anti-coagulant and anti-platelet treatment on patients'thrombosis process.Methods From January 2005 to July 2007,8 patients who had undergone endovascular stent-graft during the past 1 to 7 months for type B aortic dissection repair,underwent percutaneous coronary intervention(PCI)because of coexisting coronary artery disease.Anti-coagulant and anti-platelet treatments were administrated after PCI according to the standard protocol.Patients were followed up for a mean period of 23 months.Clinical and false lumen status data were collected during the follow-up.Results PCI were technically successful in all 8 patients and no severe complications such as death,paraplegia,renal failure occurred during hospitalization.Complete false lumen thrombosis was observed in 5 patients and incomplete false lumen thrombosis in the remained 3 patients at the end of follow up.There were no major complications such as death,dissection rupture or aneurysm development occurred during the follow-up period.Conclusion Our data implied that PCI can be safely performed in patients with type B aortic dissection who have undergone endovascular stent-graft,without interrupt-ing the thrombosis process.

Long-distance Tele-robotic-assisted Percutaneous Coronary Intervention:A Case Report of First-inpatient in China

Robotic-assisted percutaneous coronary intervention(R-PCI)is an innovative way of performing percutaneous coronary intervention(PCI)whereby the operator can manipulate coronary intraluminal guidewires and catheter devices by using remotely controlled technology.Performing tele-R-PCI from a remote location via fifth generation network communication technology has never been reported in China;however,if this were possible,the technique could be used to treat many patients with coronary artery disease who would otherwise not have the opportunity of treatment.The case of a 73-year-old male patient with coronary artery disease who underwent successful tele-R-PCI at 800 km from the operators is presented.Performing long-distance teleR-PCI in patients with coronary artery disease is feasible with predictably successful outcomes when reliable network connectivity and local cardiac catheterization facilities are present.

A Randomized Controlled Trial of a Biodegradable Polymer,Microcrystalline Sirolimus-Eluting Stent(MiStent)versus Another Biodegradable Polymer Sirolimus-Eluting Stent(TIVOLI):The DESSOLVE-C Trial

Objective::Data comparing the outcomes of MiStent(Micell Technologies,Durham,North Carolina,USA)microcrystalline biodegradable polymer(BP)drug-eluting stent(DES)and those of another post-marketing BP-DES,TIVOLI(EssenTech,Beijing,China)are rare.This study sought to compare the angiographic efficacy and clinical outcomes of the microcrystalline BP sirolimus-eluting stent(SES)system MiStent and those of TIVOLI BP-SES.Methods::The DESSOLVE-C trial was a prospective,single-blinded,multicenter,randomized trial(NCT02448524),which randomly assigned patients with de novo coronary lesions to receive MiStent or TIVOLI BP-SES by a 1:1 ratio.The primary endpoint was a non-inferiority comparison of in-stent late lumen loss(LLL)by quantitative coronary angiography at 9 months.The secondary endpoint was device-related clinical cardiovascular composite events(target lesion failure(TLF),composite of cardiac death,target vessel myocardial infarction(MI),and clinically driven target lesion revascularization)and 1-year outcomes.Results::A total of 428 patients(216 patients in the MiStent group and 212 patients in the TIVOLI group)were enrolled and included in an intention-to-treat analysis.MiStent was not only non-inferior but superior to TIVOLI for in-stent LLL at 9 months((0.23±0.37)mm vs.(0.34±0.48)mm,P for non-inferiority<0.001,P for superiority=0.02).Although without significant difference,the rate of TLF in MiStent was quantitatively lower than that in TIVOLI(3.70%vs.6.60%;P=0.17).Conclusion::Compared with TIVOLI BP-SES,the MiStent system was superior in in-stent LLL at 9 months and had a comparable clinical benefit at 1 year in de novo coronary lesions.