Feasibility and safety of a transradial approach in intervention for chronic total occlusion of coronary arteries: a single-center experience.

Background: The transradial approach for cardiac catheterization has become popular; however, its application in percutaneous coronary intervention (PCI) for chronic total occlusion (CTO) has rarely been reported. This study examines the feasibility and safety of this approach for performing PCI for CTO lesions.

Method: We retrospectively evaluated 419 consecutive patients who underwent PCI for CTO lesions between February 1998 and December 2003 in our hospital; a transradial artery approach was used in 400 patients and a transfemoral artery approach in 19.

Results: The baseline clinical characteristics were similar in the 2 patient groups. The transradial group had more de novo lesions (76% vs 47.37%, p = 0.012), fewer in-stent restenotic lesions (11.75% vs 36.84%, p = 0.006) and smaller guiding catheters (p < 0.001) than the transfemoral group. There was no statistical difference in the procedure success rates (69.25% and 78.95%, p = 0.369) between the 2 groups. The incidence of major complications, including death, Q wave myocardial infarction, and emergency coronary artery bypass surgery, was similar in the 2 groups.

Conclusions: The transradial approach for PCI can be a feasible choice for a CTO lesion. If this approach fails because of poor back up support from the guiding catheter, the transfemoral approach can be attempted with a larger guiding catheter.