Orbital Atherectomy Via Transradial Access: A Multicenter Propensity-Matched Analysis.

AIMS: The main objective of this study was to assess the safety and feasibility of orbital atherectomy (OA) with transradial access compared with more traditional femoral access.
METHODS: This multicenter, observational study included five tertiary-care centers. Out of the 39,870 who underwent percutaneous coronary intervention between January 2011 and January 2017, a total of 433 patients treated with coronary OA were identified and divided in two groups based on arterial access site. The co-primary outcomes of this study were major bleeding, associated blood transfusion, and safety outcomes. A propensity score was generated to match for baseline characteristics to avoid potential selection bias.
RESULTS: Transradial access was associated with significantly reduced major bleeding and blood transfusion in both the unadjusted model (0.6% vs 4.4% [P=.02] and 0.6% vs 4.8% [P=.02], respectively) and the propensity-score matched model (0.8% vs 6.5% [P=.045 for both]). There were no differences in safety outcomes, contrast use, fluoroscopy time, or any other secondary outcomes.
CONCLUSIONS: In this real-world, multicenter, observational study, OA via transradial access was both safe and feasible. Furthermore, transradial access was associated with reduced bleeding complications and associated blood transfusion when compared with femoral access.