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

The main objective of this study was to assess the safety and feasibility of orbital atherectomy (OA) with transradial access compared with more traditional femoral access.

This multicenter, observational study included five tertiary-care centers. Out of the 39,870 who underwent percutaneous coronary intervention between January 2011 and January 2017, a total of 433 patients treated with coronary OA were identified and divided in two groups based on arterial access site. The co-primary outcomes of this study were major bleeding, associated blood transfusion, and safety outcomes. A propensity score was generated to match for baseline characteristics to avoid potential selection bias.

Transradial access was associated with significantly reduced major bleeding and blood transfusion in both the unadjusted model (0.6% vs 4.4% [P=.02] and 0.6% vs 4.8% [P=.02], respectively) and the propensity-score matched model (0.8% vs 6.5% [P=.045 for both]). There were no differences in safety outcomes, contrast use, fluoroscopy time, or any other secondary outcomes.

In this real-world, multicenter, observational study, OA via transradial access was both safe and feasible. Furthermore, transradial access was associated with reduced bleeding complications and associated blood transfusion when compared with femoral access.