ABSTRACT
Background: Aim of the study was to evaluate the primary procedural success of slender PCI via transradial approach using either Bare-metal stents (BMS) or Drug Eluting Stent (DES). Methods: Total 10 patients were enrolled in this very preliminary study. Among them, Male: 8 and Female: 2. Clinical presentation were Ant MI: 4 (40%), Inf. MI: 2 (20%), Angina II-III: 3 (30%), and NSTEMI: 1 (10%). Total 10 stents were deployed. Mean age were for Male: 44yrs, for Female: 55yrs . Associated CAD risk factors were Dyslipidemia, High Blood pressure, Diabetes Mellitus, Positive FH for CAD and Smoking (all male). Results: Among the study group; 9 (90%) were Dyslipidemic, 5 (50%) were hypertensive; 6 (60%) patients were Diabetic, FH 6 (6%) and 8(63%) were all male smoker. Female patients were more obese (BMI M 24: F 27) and developed CAD in advance age. Common stented territory were LAD: 5 (50%) followed by RCA: 3 (30%) and LCX: 2 (20%). Average length and diameter of stent for LAD, RCA and LCX were 3.25, 3.16, 2.5 and 21.4, 20.3, 20 respectively. Stent used: BMS 3 (30%), Everolimus 5 (50%), Sirolimus 1(10%) and Zotarolimus 1(0.75%). Less contrast used (49.5ml), reduced radiation exposure (4727Gym2) and less fluoroscopy time (193 sec) with overall no procedural complication were observed. Conclusion: Our study has shown that the slender PCI via radial artery with a 5F guide catheter is safe with no procedural complication. It is also associated with less radiation exposure, less fluoroscopy time, good backup support and quick mobilization of patient.
ABSTRACT
Trans-radial (TR) approach is increasingly recognized as an alternative to the routine use of trans-femoral (TF) approach. However, there are limited data comparing the outcomes of these two approaches for the treatment of coronary bifurcation lesions. We evaluated outcomes of TR and TF percutaneous coronary interventions (PCI) in this complex lesion. Procedural outcomes and clinical events were compared in 1,668 patients who underwent PCI for non-left main bifurcation lesions, according to the vascular approach, either TR (n = 503) or TF (n = 1,165). The primary outcome was major adverse cardiac events (MACE), including cardiac death, myocardial infarction (MI), and target lesion revascularization (TLR) in all patients and in 424 propensity-score matched pairs of patients. There were no significant differences between TR and TF approaches for procedural success in the main vessel (99.6% vs 98.6%, P = 0.08) and side branches (62.6% vs 66.7%, P = 0.11). Over a mean follow-up of 22 months, cardiac death or MI (1.8% vs 2.2%, P = 0.45), TLR (4.0% vs 5.2%, P = 0.22), and MACE (5.2% vs 7.0%, P = 0.11) did not significantly differ between TR and TF groups, respectively. These results were consistent after propensity score-matched analysis. In conclusion, TR PCI is a feasible alternative approach to conventional TF approaches for bifurcation PCI (clinicaltrials.gov number: NCT00851526).