The Experience of Transradial Coronary Intervention for Chronic Total Occlusion

ABSTRACT

BACKGROUND AND OBJECTIVE: We try to evaluate the feasibility of transradial approach in patients with a chronic total occlusion. SUBJECTS AND METHODS: Between Mar., 2000 and Oct., 2002, 52 consecutive patients, with 54 lesions, underwent transradial coronary intervention for a chronic total occlusion, which was defined as duration of an occlusion of more than 1 month. The patients were divided into the success or failure group, with the clinical, angiographic and procedural factors compared between the two groups. RESULTS: The overall success rate of the transradial approach was 57.7% (31/54). The most common cause of failure of the transradial coronary intervention was an inability to pass the lesions using a guidewire (17 of 23 failures, 74%). Five cases were crossed over to the femoral artery due to an approach failure of the guiding catheter into the coronary ostium; severe subclavian tortuosity and stenosis in 2 cases, radial artery looping in 1 and poor guiding support in the other 2. A procedural success was more common in lesions with no side branch, no bridging collateral, short duration of occlusion and lesions less than 15mm in length. Non-Q wave myocardial infarction occurred in 1 case. There were no major entry site complications. CONCLUSION: The radial artery might be a feasible vascular route in the percutaneous coronary intervention of chronic total occlusions with comparable procedural success rates and no major access site complications.