Background Totally radial access(TRA) is getting popular in coronary chronic total occlusion(CTO) percutaneous coronary intervention(PCI). but it has been associated with a non-negligible risk of complications. Method...Background Totally radial access(TRA) is getting popular in coronary chronic total occlusion(CTO) percutaneous coronary intervention(PCI). but it has been associated with a non-negligible risk of complications. Methods This retrospective study included 1760 CTO patients underwent PCI from January 2015 to January 2018.Patients were divided into two groups: TRA group was referred to single radial or double radial access;Femoral access(FA) group was referred to single FA, double FA, FA and RA. The primary efficacy endpoint was procedural success, which was defined as technical success without in-hospital MACE. The primary safety endpoint was a composite of vascular complications and major bleeding. Results TRA was applied in 482 cases, while FA in 1278 cases. Mean J-CTO scores was higher in FA group(2.5±1.0 vs. 2.0±0.9, P=0.001). Procedural success showed no significant difference between both groups(82.9% vs. 83.6%, P=0.823). The primary safety endpoint was higher in FA group(11.4 vs. 4.1%, P<0.001). On multivariate analysis, FA approach was independently associated with the primary safety endpoint [odds ratio;(OR) 2.887, 95% confidence interval(CI) 1.759-4.739,P=0.001], after adjusting for age, diabetes, body mass index, prior CABG, and J-CTO score. Conclusions TRA for CTO PCI might be associated with lower incidence of a composite endpoint of vascular complications and major bleeding, while maintaining similarly high success rates.[S Chin J Cardiol 2019;20(4):211-216]展开更多
基金supported by the Science and Technology Innovation Project from Foshan,Guangdong(No.FS0AA-KJ218-1301-0010)
文摘Background Totally radial access(TRA) is getting popular in coronary chronic total occlusion(CTO) percutaneous coronary intervention(PCI). but it has been associated with a non-negligible risk of complications. Methods This retrospective study included 1760 CTO patients underwent PCI from January 2015 to January 2018.Patients were divided into two groups: TRA group was referred to single radial or double radial access;Femoral access(FA) group was referred to single FA, double FA, FA and RA. The primary efficacy endpoint was procedural success, which was defined as technical success without in-hospital MACE. The primary safety endpoint was a composite of vascular complications and major bleeding. Results TRA was applied in 482 cases, while FA in 1278 cases. Mean J-CTO scores was higher in FA group(2.5±1.0 vs. 2.0±0.9, P=0.001). Procedural success showed no significant difference between both groups(82.9% vs. 83.6%, P=0.823). The primary safety endpoint was higher in FA group(11.4 vs. 4.1%, P<0.001). On multivariate analysis, FA approach was independently associated with the primary safety endpoint [odds ratio;(OR) 2.887, 95% confidence interval(CI) 1.759-4.739,P=0.001], after adjusting for age, diabetes, body mass index, prior CABG, and J-CTO score. Conclusions TRA for CTO PCI might be associated with lower incidence of a composite endpoint of vascular complications and major bleeding, while maintaining similarly high success rates.[S Chin J Cardiol 2019;20(4):211-216]
