Feasibility of single catheter intervention for multivessel coronary artery disease using transradial approach

The objective of the study was to describe the feasibility of single catheter intervention using the transradial approach for percutaneous coronary intervention (PCI).

The transradial approach for PCIs has fewer vascular events and complications and lower mortality rate. However, complications can result from forearm artery tortuosity, a longer learning curve and artery spasm that can complicate, delay and impede coronary artery interventions. The latter is usually exacerbated by the changing and manipulation of catheters.

We performed a study using a single catheter on patients undergoing coronary assessment and treatment. Procedural outcomes including success, procedural time, bleeding, access site complications, and contrast used were all analyzed.

We included 327 patients, of whom 70% were male. The mean age was 63.3 ± 11.1 years, mean height was 165.9 ± 7.7 cm, mean weight was 73.3 ± 11.3 kg, and mean body index was 26.5 ± 3.5 kg/m². Contrast use averaged 158.5 ± 60.5 ml. Three vessels were treated in 3% of all cases, two vessels in 32%, and one vessel in 65%. Procedural success was achieved in 94.5% of the cases. A second catheter was required in 9 cases (2.7%), and crossover to the femoral approach was performed in 9 cases (2.7%) due to a lack of support, artery spasm, difficult anatomy, or the need for a larger catheter. Three complications were related to access, including a Class 2 hematoma that was treated conservatively with no further complications.

Our study showed that using a single catheter to perform both diagnostic and therapeutic procedures has a higher success rate, lower spasm incidence, and fewer complications than reported in literature.