Orbital Atherectomy Via Transradial Access: A Multicenter Propensity-Matched Analysis.

Area of Science:

• Interventional Cardiology
• Vascular Access Techniques
• Cardiovascular Interventions

Background:

• Orbital atherectomy (OA) is a percutaneous coronary intervention technique.
• Arterial access for OA typically involves femoral or radial approaches.
• Comparing the safety and feasibility of these access sites is crucial for patient outcomes.

Purpose of the Study:

• To evaluate the safety and feasibility of orbital atherectomy (OA) using transradial access.
• To compare transradial access with traditional femoral access for OA procedures.
• To assess complication rates, specifically major bleeding and blood transfusion requirements.

Main Methods:

• A multicenter, observational study involving 433 patients undergoing coronary OA.
• Patients were divided into transradial access and femoral access groups.
• Propensity score matching was used to control for baseline differences between groups.

Main Results:

• Transradial access showed significantly lower rates of major bleeding (0.8% vs 6.5%, P=.045) and blood transfusion (0.8% vs 6.5%, P=.045) in the matched cohort.
• No significant differences were observed in safety outcomes, contrast use, or fluoroscopy time.
• Both unadjusted and propensity-score matched analyses supported the reduced bleeding risk with transradial access.

Conclusions:

• Orbital atherectomy via transradial access is a safe and feasible option in real-world clinical practice.
• Transradial access is associated with a significant reduction in bleeding complications and the need for blood transfusions compared to femoral access.
• The findings support transradial access as a preferred approach for OA when feasible.