Transradial intervention via large-bore guide catheters: a study of coronary bifurcation disease treatment using the...

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Access

Background:

• Transradial access (TRA) for coronary intervention minimizes vascular complications and major adverse cardiovascular events.
• The radial artery's small caliber traditionally limits complex interventions.
• True bifurcation lesions often require complex strategies like two-stent techniques.

Purpose of the Study:

• To evaluate the feasibility and outcomes of crush stenting for true bifurcation disease using the transradial approach.
• To assess procedural success and medium-term clinical outcomes in patients undergoing complex PCI via TRA.

Main Methods:

• A prospective study involving 53 patients with true bifurcation disease indicated for a two-stent strategy.
• Crush stenting performed via the transradial approach.
• Procedural outcomes and 6- and 18-month clinical follow-up were meticulously recorded.

Main Results:

• Successful crush stenting was achieved in 93% of lesions (51/55).
• Successful final kissing inflation was accomplished in 96% of cases (51/53).
• No in-hospital or procedural complications were reported; 18-month follow-up showed a 9.8% rate of death, myocardial infarction, or target vessel revascularization.

Conclusions:

• Complex percutaneous coronary intervention (PCI), including crush stenting, can be successfully performed via the transradial approach in a high proportion of patients.
• The transradial approach for crush stenting demonstrated excellent procedural success and favorable medium-term clinical outcomes.
• High rates of final kissing inflation were achieved, contributing to the positive results.