Related Experiment Video
Updated: Apr 4, 2026
Transradial Access Chemoembolization for Hepatocellular Carcinoma Patients
Published on: September 20, 2020
The Efficacy and Feasibility of Chronic Total Occlusion by Transradial Intervention: A Japanese Single-Center
Tsutomu Murakami, Naoki Masuda, Sho Torii
1Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, Kanagawa, 259-1193, Japan. ikari@is.icc.u-tokai.ac.jp.
Insights
Transradial intervention (TRI) is effective for treating chronic total occlusions (CTOs), demonstrating high success and low complication rates. Careful patient selection is key for optimal outcomes in CTO treatment using TRI.
Area of Science:
- Cardiovascular Interventions
- Interventional Cardiology
- Vascular Access Techniques
Background:
- Transradial intervention (TRI) is increasingly used for complex percutaneous coronary interventions.
- The efficacy and feasibility of TRI compared to transfemoral intervention (TFI) for chronic total occlusions (CTOs) remain under investigation.
Purpose of the Study:
- To evaluate the effectiveness and safety of transradial intervention (TRI) for treating chronic total occlusions (CTOs).
- To compare TRI with transfemoral intervention (TFI) in the context of CTO treatment.
Main Methods:
- Retrospective analysis of 207 CTO lesions in 195 patients undergoing TRI or TFI.
- Patients categorized into four procedural groups: TRI, TFI, TRI/TFI, and TFI/TFI.
- Evaluation of antegrade and antegrade plus retrograde approaches.
Main Results:
- No significant difference in procedural success rates between TRI (82.2%), TFI (72.5%), TRI/TFI (75.0%), and TFI/TFI (75.0%).
- Lower average sheath size in TRI (5.7 Fr) compared to TFI (6.6 Fr).
- No 30-day mortality, myocardial infarction, or stroke; access-site complications were lower in radial cases.
Conclusions:
- Transradial intervention (TRI) can achieve high success rates and low complication rates for treating a significant proportion of chronic total occlusions (CTOs).
- Careful selection of CTO lesions is crucial for successful TRI outcomes.
Objectives:
To evaluate transradial intervention (TRI) for chronic total occlusion (CTO).
Background:
Although TRI has been applied to more complex lesions in percutaneous coronary intervention, efficacy and feasibility of TRI versus transfemoral intervention (TFI) for CTO have not yet been determined.
Methods:
We retrospectively analyzed 207 CTO lesions in 195 patients in a single center between January 2008 and December 2011. Patients were divided into four groups according to procedures: TRI (135 lesions in 124 patients); TFI (40 lesions in 39 patients); TRI/TFI (20 lesions in 20 patients); and TFI/TFI (12 lesions in 12 patients). Antegrade approach was used in TRI and TFI, but antegrade plus retrograde approach was used in TRI/TFI and TFI/TFI.
Results:
Although there were no differences in patient characteristics, complex CTO lesions such as blunt-type entry and retry lesions were frequently observed in the TFI/TFI group. Average sheath size was 5.7 Fr for TRI and 6.6 Fr for TFI. Fluoroscopy time was significantly longer for the antegrade plus retrograde approach. Procedure success rates were not statistically different: 82.2% in TRI, 72.5% in TFI, 75.0% in TRI/TFI, and 75.0% in TFI/TFI groups. There was no death, myocardial infarction, or stroke at 30 days in any groups. Two femoral cases and no radial cases had access-site complications. Access-site crossover from radial to femoral was conducted in 4 cases.
Conclusion:
More than one-half of CTO lesions can be treated with high success and low complication rates by TRI if the lesions are carefully selected.
