Short- and Long-Term Follow-up of Percutaneous Coronary Intervention for Chronic Total Occlusion through Transradial Approach: Tips for Successful Procedure from a Single-Center Experience

Abstract

There are limited data regarding transradial percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). To assess the feasibility and safety of transradial coronary intervention (TRI) for CTO lesions, we analyzed our experience in PCI treatment of CTO lesion through transradial approach for the past 6 years. From January 2003 to May 2009, among 134 CTO lesions, on which we performed PCI, 120 lesions were performed from transradial approach. Technical success for transradial CTO was 80%. Complication of access bleeding was zero. The most commonly selected guiding wire was Wave 3 for right coronary artery (RCA) lesions (82%) and Voda left for Left Coronary Artery (LCA) lesions (91%). The average number of wires used during procedure was 2.2 ± 0.8. Tapered wire was used in 8% of the cases, Rotablator was performed in 4.1% of cases, and Tornus catheter was performed in 12.5% of cases. The mean procedure time was 83 ± 39 minutes. The mean volume of contrast medium used was 228 ± 92 mL. There were two coronary artery perforations during procedure and one in-hospital cardiac death. Patients were followed up for 36 ± 21 months; restenosis rate was 19.5%-26.7% for bare metal stent (BMS) and 9.8% for drug-eluting stents (DES). Overall major adverse cardiac events (MACE) rate was 11.7%. It was demonstrated that transradial PCI for CTO lesions is safe, minimizing vascular complications without increasing procedural time and contrast use.