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Transradial coronary intervention in Japanese patients
S Saito1, S Miyake, G Hosokawa
1Division of Cardiology and Catheterization Laboratories, ShonanKamakura Hospital, Kamakura, Japan. saito@shonankamakura.or.jp
Insights
Transradial coronary intervention (TRI) is feasible and safe for Japanese patients. This approach demonstrated significantly lower local complications compared to transfemoral coronary intervention (TFI).
Area of Science:
- Cardiology
- Vascular Surgery
Background:
- Transfemoral coronary intervention (TFI) is a common procedure.
- Transradial coronary intervention (TRI) offers potential advantages but requires evaluation in diverse populations.
Purpose of the Study:
- To assess the feasibility and safety of transradial coronary intervention (TRI) in Japanese patients.
- To compare TRI outcomes with transfemoral coronary intervention (TFI) in this population.
Main Methods:
- Retrospective comparison of TRI (1,791 lesions/1,360 patients) and TFI (966 lesions/793 patients).
- Evaluation of success rates (arterial puncture, cannulation, lesion, patient) and major/local complication rates.
- Post-procedure radial artery assessment (palpation, Doppler) in 294 patients to determine occlusion rates.
Main Results:
- Similar success rates were observed between TRI and TFI groups.
- Major complication rates showed no significant difference between the two methods.
- Local complications were significantly lower in the TRI group (0.3% vs. 3.3%, P < 0.001).
- Radial artery occlusion rates were 5% when sheath removal was delayed by 3 hours, and 0% when removed immediately post-procedure.
Conclusions:
- Transradial coronary intervention (TRI) is a safe and feasible option for Japanese patients.
- TRI is associated with a significant reduction in local complications compared to TFI.
- Immediate sheath removal post-TRI minimizes the risk of radial artery occlusion.
Abstract:
The objectives of this study was to test the feasibility and safety of transradial coronary intervention (TRI) in Japanese patients. We compared the results of TRI in 1,791 lesions (1,360 patients) between November 1995 and December 1997 with those of transfemoral coronary intervention (TFI) in 966 lesions (793 patients) between April and October 1995. We also examined the radial artery pulse in 294 patients 1-2 weeks after TRI by palpation and Doppler examination. Arterial puncture, coronary artery cannulation, lesion, and patient success rates were similar in both groups. No significant difference was noted in the major complication rate. Local complications were significantly lower in the TRI group (0.3% vs. 3.3%, P < 0.001). Doppler studies of the radial artery were performed in 294 patients chosen at random. In the first 234 patients, the sheath was pulled out 3 hr after the procedure, and in the last 60 patients, immediately after the procedure; radial artery occlusion rates were 5% and 0%, respectively. In conclusion, TRI seems safe and feasible in Japanese patients.