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Feasibility and safety of 7-Fr radial approach for complex PCI
1Cardiac Department, Freeman Hospital, Newcastle Upon Tyne, UK. m.egred@nuth.nhs.uk
Insights
Complex percutaneous coronary intervention (PCI) using a 7-French transradial approach is safe and effective. This method offers excellent procedural success and outcomes, challenging the traditional femoral approach for complex PCI cases.
Area of Science:
- Cardiology
- Interventional Cardiology
Background:
- The transradial approach is standard for percutaneous coronary intervention (PCI).
- However, it's often perceived as unsuitable for 7-French complex PCI, typically done via the femoral approach.
Purpose of the Study:
- To assess the feasibility, procedural success, and outcomes of 7-French transradial complex PCI.
Main Methods:
- Retrospective analysis of 77 patients undergoing 7-French transradial complex PCI.
- Procedures were performed between August 2008 and October 2010 in a tertiary cardiac center.
Main Results:
- Successful radial access in all 77 patients.
- High procedural success rate (98.7%), with one failure to cannulate a chronic total occlusion (CTO).
- Excellent safety profile with no in-hospital mortality and patent radial arteries post-procedure.
Conclusions:
- 7-French transradial complex PCI is feasible, safe, and yields excellent results.
- It provides a viable alternative to the femoral approach for suitable patients undergoing complex PCI.
Background:
Although the transradial approach is well established for percutaneous coronary intervention (PCI), it is perceived as being not suitable for 7-Fr complex PCI, which is traditionally performed from the femoral approach.
Objective:
To evaluate the procedural success and outcome of 7-Fr transradial complex PCI.
Method:
Retrospective review and analysis of all patients undergoing 7-Fr transradial complex PCI from August 2008 until October 2010 in a tertiary cardiac center setting.
Results:
Transradial 7-Fr complex PCI was performed in 77 patients after manual assessment of the radial pulse and size. The radial access was obtained successfully in all 77 patients. The age range was 39-88 years with 16 patients (23.4%) over 80 years of age and 14 females (18.1%). There were 30 left main stem PCI (39%), 31 (40.2%) chronic total occlusion (CTO), and 13 (16.8%) rotational atherectomy. Intravascular ultrasound (IVUS) was used in 17 (22%) cases, cutting balloons in 16 (20.7%), and LASER PCI in 2 (2.6%) cases. Procedural success was achieved in 76 of 77 (98.7%) with 1 failure to canalize a CTO. There was 1 patient with type I coronary perforation managed conservatively. There was no in-hospital mortality. All radial pulses were present 6 hours after the procedure and only 23 patients were seen for follow-up, and all had patent radial artery 4-6 months following the procedure.
Conclusion:
A 7-Fr transradial complex PCI is feasible and can be carried out safely and successfully with excellent results. In suitable patients, male or female, complex PCI need not always be performed from the femoral approach.
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