OBJECTIVES: To examine the impact of transradial access on the procedural outcomes of chronic total occlusion (CTO) percutaneous coronary interventions (PCI). BACKGROUND: The efficacy and safety of transradial access in CTO PCI has received limited study. METHODS: We compared the technique and outcomes of transradial vs. transfemoral access among 650 CTO PCI cases performed between January 2012 and March 2014 at 6 US centers. RESULTS: Most patients were men (87%) with high frequency of diabetes mellitus (42%) and prior coronary artery bypass graft surgery (36%). The CTO target vessel was the right coronary (59%), left anterior descending (20%), or circumflex (17%) artery. TR access was used in 110 (17%) of the 650 cases, as follows: bilateral radial access (63%); bilateral radial access plus unilateral or bilateral femoral access (7%); unilateral radial access plus unilateral or bilateral femoral access (26%); and unilateral radial access (4%). Six and eight French guide catheters were used through the radial and femoral artery, respectively. Compared to transfemoral, transradial cases had similar technical (92.6% vs. 93.0%, P = 0.87) and procedural (91.1% vs. 90.0%, P = 0.95) success and major complication rates (1.7% vs 1.8%, P = 0.99). However, transradial access was associated with higher mean procedure (142 ± 83 vs. 120 ± 60 min, P = 0.008) and fluoroscopy (58 ± 40 vs. 49 ± 31 min, P <0.026) time, and number of crossing approach changes (0.7 ± 1.0 vs. 0.5 ± 0.7, P = 0.008). CONCLUSION: Transradial CTO PCI can be performed with similar success and complication rates with transfemoral CTO PCI, but is associated with longer procedural and fluoroscopy times.
OBJECTIVES: To examine the impact of transradial access on the procedural outcomes of chronic total occlusion (CTO) percutaneous coronary interventions (PCI). BACKGROUND: The efficacy and safety of transradial access in CTO PCI has received limited study. METHODS: We compared the technique and outcomes of transradial vs. transfemoral access among 650 CTO PCI cases performed between January 2012 and March 2014 at 6 US centers. RESULTS: Most patients were men (87%) with high frequency of diabetes mellitus (42%) and prior coronary artery bypass graft surgery (36%). The CTO target vessel was the right coronary (59%), left anterior descending (20%), or circumflex (17%) artery. TR access was used in 110 (17%) of the 650 cases, as follows: bilateral radial access (63%); bilateral radial access plus unilateral or bilateral femoral access (7%); unilateral radial access plus unilateral or bilateral femoral access (26%); and unilateral radial access (4%). Six and eight French guide catheters were used through the radial and femoral artery, respectively. Compared to transfemoral, transradial cases had similar technical (92.6% vs. 93.0%, P = 0.87) and procedural (91.1% vs. 90.0%, P = 0.95) success and major complication rates (1.7% vs 1.8%, P = 0.99). However, transradial access was associated with higher mean procedure (142 ± 83 vs. 120 ± 60 min, P = 0.008) and fluoroscopy (58 ± 40 vs. 49 ± 31 min, P <0.026) time, and number of crossing approach changes (0.7 ± 1.0 vs. 0.5 ± 0.7, P = 0.008). CONCLUSION: Transradial CTO PCI can be performed with similar success and complication rates with transfemoral CTO PCI, but is associated with longer procedural and fluoroscopy times.
Authors: J R Martinez-Parachini; A Karatasakis; D Karmpaliotis; K Alaswad; F A Jaffer; R W Yeh; M Patel; J Bahadorani; A Doing; P-K Nguyen-Trong; B A Danek; J Karacsonyi; A Alame; B V Rangan; C A Thompson; S Banerjee; E S Brilakis Journal: Diabet Med Date: 2016-11-03 Impact factor: 4.359
Authors: Barbara A Danek; Aris Karatasakis; Dimitri Karmpaliotis; Khaldoon Alaswad; Farouc A Jaffer; Robert W Yeh; Mitul P Patel; John Bahadorani; William L Lombardi; R Michael Wyman; J Aaron Grantham; David E Kandzari; Nicholas J Lembo; Anthony H Doing; Catalin Toma; Jeffrey W Moses; Ajay J Kirtane; Ziad A Ali; Manish Parikh; Santiago Garcia; Phuong-Khanh Nguyen-Trong; Judit Karacsonyi; Aya J Alame; Pratik Kalsaria; Craig Thompson; Subhash Banerjee; Emmanouil S Brilakis Journal: Can J Cardiol Date: 2016-04-22 Impact factor: 5.223
Authors: Barbara Anna Danek; Aris Karatasakis; Dimitri Karmpaliotis; Khaldoon Alaswad; Robert W Yeh; Farouc A Jaffer; Mitul Patel; John Bahadorani; William L Lombardi; Michael R Wyman; J Aaron Grantham; Anthony Doing; Jeffrey W Moses; Ajay Kirtane; Manish Parikh; Ziad A Ali; Sanjog Kalra; David E Kandzari; Nicholas Lembo; Santiago Garcia; Bavana V Rangan; Craig A Thompson; Subhash Banerjee; Emmanouil S Brilakis Journal: Int J Cardiol Date: 2016-04-06 Impact factor: 4.164
Authors: Dimitri Karmpaliotis; Aris Karatasakis; Khaldoon Alaswad; Farouc A Jaffer; Robert W Yeh; R Michael Wyman; William L Lombardi; J Aaron Grantham; David E Kandzari; Nicholas J Lembo; Anthony Doing; Mitul Patel; John N Bahadorani; Jeffrey W Moses; Ajay J Kirtane; Manish Parikh; Ziad A Ali; Sanjog Kalra; Phuong-Khanh J Nguyen-Trong; Barbara A Danek; Judit Karacsonyi; Bavana V Rangan; Michele K Roesle; Craig A Thompson; Subhash Banerjee; Emmanouil S Brilakis Journal: Circ Cardiovasc Interv Date: 2016-06 Impact factor: 6.546
Authors: Judit Karacsonyi; Aris Karatasakis; Dimitri Karmpaliotis; Khaldoon Alaswad; Robert W Yeh; Farouc A Jaffer; Michael R Wyman; William L Lombardi; J Aaron Grantham; David E Kandzari; Nicholas Lembo; Jeffrey W Moses; Ajay J Kirtane; Manish A Parikh; Philip Green; Matthew Finn; Santiago Garcia; Anthony Doing; Mitul Patel; John Bahadorani; Jose Roberto Martinez Parachini; Erica Resendes; Bavana V Rangan; Imre Ungi; Craig A Thompson; Subhash Banerjee; Emmanouil S Brilakis Journal: Am J Cardiol Date: 2016-01-28 Impact factor: 2.778
Authors: Santiago Garcia; M Chadi Alraies; Aris Karatasakis; Demetris Yannopoulos; Dimitri Karmpaliotis; Khaldoon Alaswad; Farouc A Jaffer; Robert W Yeh; Mitul P Patel; John Bahadorani; Judit Karacsonyi; Pratik Kalsaria; Barbara Danek; Subhash Banerjee; Emmanouil S Brilakis Journal: Catheter Cardiovasc Interv Date: 2016-11-10 Impact factor: 2.692
Authors: Georgios E Christakopoulos; Dimitri Karmpaliotis; Khaldoon Alaswad; Robert W Yeh; Farouc A Jaffer; R Michael Wyman; William Lombardi; J Aaron Grantham; David A Kandzari; Nicholas Lembo; Jeffrey W Moses; Ajay Kirtane; Manish Parikh; Philip Green; Matthew Finn; Santiago Garcia; Anthony Doing; Mitul Patel; John Bahadorani; Georgios Christopoulos; Aris Karatasakis; Craig A Thompson; Subhash Banerjee; Emmanouil S Brilakis Journal: J Invasive Cardiol Date: 2016-07 Impact factor: 2.022
Authors: Barbara Anna Danek; Aris Karatasakis; Dimitri Karmpaliotis; Khaldoon Alaswad; Robert W Yeh; Farouc A Jaffer; Mitul P Patel; Ehtisham Mahmud; William L Lombardi; Michael R Wyman; J Aaron Grantham; Anthony Doing; David E Kandzari; Nicholas J Lembo; Santiago Garcia; Catalin Toma; Jeffrey W Moses; Ajay J Kirtane; Manish A Parikh; Ziad A Ali; Judit Karacsonyi; Bavana V Rangan; Craig A Thompson; Subhash Banerjee; Emmanouil S Brilakis Journal: J Am Heart Assoc Date: 2016-10-11 Impact factor: 5.501
Authors: Judit Karacsonyi; Khaldoon Alaswad; Farouc A Jaffer; Robert W Yeh; Mitul Patel; John Bahadorani; Aris Karatasakis; Barbara A Danek; Anthony Doing; J Aaron Grantham; Dimitri Karmpaliotis; Jeffrey W Moses; Ajay Kirtane; Manish Parikh; Ziad Ali; William L Lombardi; David E Kandzari; Nicholas Lembo; Santiago Garcia; Michael R Wyman; Aya Alame; Phuong-Khanh J Nguyen-Trong; Erica Resendes; Pratik Kalsaria; Bavana V Rangan; Imre Ungi; Craig A Thompson; Subhash Banerjee; Emmanouil S Brilakis Journal: J Am Heart Assoc Date: 2016-08-20 Impact factor: 5.501