Vascular Assisted Tracking for Challenging Transradial Percutaneous Intervention.

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Access

Background:

• Transradial approach (TRA) is preferred for coronary angiography and PCI.
• High access site crossover rates remain a challenge in TRA-PCI.
• Assisted-tracking techniques (AsTra) show promise for difficult TRA procedures.

Purpose of the Study:

• To evaluate the efficacy and safety of assisted-tracking (AsTra) techniques in transradial percutaneous coronary intervention (TRA-PCI).
• To assess the impact of AsTra techniques on TRA-PCI success rates and access site crossover.

Main Methods:

• Retrospective analysis of 1682 TRA-PCI procedures from January 2016 to December 2019.
• Adoption of AsTra techniques in 72 challenging TRA-PCI cases starting January 2018.
• Comparison of TRA-PCI rates between interventionalists who adopted AsTra and those who did not.

Main Results:

• TRA-PCI rates increased from 68.5% to 95% between 2016 and 2019.
• Significant increase in TRA-PCI success rates for interventionalists using AsTra techniques (p<0.0001 in 2019, p=0.003 in 2018).

Conclusions:

• Assisted-tracking techniques are effective in improving TRA-PCI rates.
• AsTra techniques are associated with low complication and access crossover rates.
• AsTra represents a valuable advancement for challenging TRA-PCI procedures.