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Using sheathless standard guiding catheters for transradial percutaneous coronary intervention to treat bifurcation
Qiyong Li1, Yong He, Rongjian Jiang
1Department of Cardiology, Sichuan Provincial People's Hospital, Sichuan Academy of Medical Science, Chengdu, China.
Insights
Sheathless transradial percutaneous coronary intervention (PCI) is a feasible and safe approach for treating coronary artery bifurcation lesions. This method demonstrated high procedural success and low complication rates in a recent study.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Surgery
Background:
- Coronary artery disease often involves complex bifurcation lesions requiring intervention.
- Transradial percutaneous coronary intervention (PCI) is a preferred approach due to its minimally invasive nature.
- The use of sheathless guiding catheters in transradial PCI for bifurcation lesions remains an area of investigation.
Purpose of the Study:
- To evaluate the feasibility and safety of employing sheathless standard guiding catheters for transradial PCI in patients with coronary artery bifurcation lesions.
Main Methods:
- A cohort of 43 patients with coronary artery disease and identified bifurcation lesions underwent transradial PCI.
- Sheathless standard guiding catheters were utilized for the procedures.
- Procedural success rates and complication profiles were meticulously recorded.
Main Results:
- All 43 PCI procedures were successfully completed.
- Various stenting techniques were employed, including Culotte (51.2%), Crush (18.8%), and crossover (30.0%).
- High rates of final kissing balloon (90.1%) and adjunctive device use (IVUS in 74.4%) were noted. No major perioperative complications occurred. At 6 months, 55.8% of patients showed coronary artery patency without significant intimal hyperplasia.
Conclusions:
- Transradial PCI utilizing a sheathless guiding catheter technique appears to be a safe and feasible option for treating coronary artery bifurcation lesions.
- The technique showed promising results regarding procedural success and low complication rates.
Objective:
To investigate the feasibility and safety of using sheathless standard guiding catheters for transradial percutaneous coronary intervention (PCI) to treat bifurcation lesions.
Methods:
Coronary bifurcation lesions were identified using angiography in 43 patients with coronary artery disease. These patients underwent transradial PCI using sheathless standard guiding catheters, and the procedural success and complication rates were recorded.
Results:
All 43 patients underwent successful PCI. The Culotte stenting technique was used in 22 (51.2%) subjects, the Crush stenting technique was used in eight (18.8%) subjects and the crossover stenting implantation technique was used in 13 (30.0%) subjects. Of the 43 coronary artery bifurcation lesions, the final kissing balloon technique was performed in 39 (90.1%) lesions. Adjunctive devices used in the cohort included intravascular ultrasound for 32 (74.4%) patients, thrombus aspiration catheters for two patients and cutting balloon for five patients. During the perioperative period, no major complications associated with vessel puncture or adverse cardiac or cerebrovascular events occurred in any of the 43 patients enrolled in the present study. At day 30, radial artery occlusion was detected in only three (2.5%) patients and radial artery stenosis in four (9.3%) patients. At six-month follow-up, 24 (55.8%) patients exhibited coronary artery patency with no significant intimal hyperplasia.
Conclusions:
Transradial PCI using the sheathless technique may be a feasible and safe technique to treat coronary bifurcation lesions.
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