The efficacy and safety of transradial and transfemoral approach in treatment of coronary chronic total occlusion: a systematic review and meta-analysis

Soud, Mohamad; SayedAhmad, Ziad; Kajy, Marvin; Alahdab, Fares; Darmoch, Fahed; Al‐Khadra, Yasser; Pacha, Homam Moussa; Sattar, Yasar; Ullah, Waqas; King, Fred; Saad, Ali B.; Alhatemi, Ghaith; Hakim, Zaher; Omar, Ali; Glazier, James J.; Alraies, M. Chadi

doi:10.1080/14779072.2020.1813025

Cited by 10 publications

(7 citation statements)

References 29 publications

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“…24 Early observational studies and the more recent ACCOAST study suggested a higher frequency of stroke with TRA, 25 26 though the aforementioned meta-analyses also examined more recent rates of stroke and found no statistical difference. 21 22 23 The data from these analyses, however, were not granular or well powered. Singh et al specifically noted that their study was unable to detect statistically significant differences in stroke incidence, as only half of the included trials reported stroke outcomes and the incidence was quite low (0.48–0.59%).…”

Section: Discussionmentioning

confidence: 94%

“…These studies have consistently demonstrated that TRA is associated with fewer complications such as periprocedural bleeding; decrease in length of hospital stay; improvement of clinical outcomes; and comparable rates of major adverse events. 20 21 22 23 In 2018, the American Heart Association recommended a “radial-first” strategy in the United States for patients with acute coronary syndromes. 24 Early observational studies and the more recent ACCOAST study suggested a higher frequency of stroke with TRA, 25 26 though the aforementioned meta-analyses also examined more recent rates of stroke and found no statistical difference.…”

Section: Discussionmentioning

confidence: 99%

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Transradial Uterine Artery Embolization Complicated by Stroke

Peters

Charles

et al. 2022

Semin intervent Radiol

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Transradial Uterine Artery Embolization Complicated by Stroke

Peters

Charles

et al. 2022

Semin intervent Radiol

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“… 5 Recently, the effectiveness and safety of TRA have been reported even in chronic total occlusion (CTO) lesions. 6 However, since the size of radial artery is smaller than femoral artery, one limitation is that the 8Fr sheath cannot be used for insertion. Therefore, the 8Fr sheathless GC system may be useful for procedures that require 8Fr GC such as DCA and intravascular ultrasound guide technique in CTO.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of the Transradial 8Fr Sheathless Guiding Catheter Approach in Directional Coronary Atherectomy

Niizeki¹,

Iwayama²,

Kumagai³

et al. 2022

Clin Med Insights Case Rep

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Background: Directional coronary atherectomy (DCA) revived in Japan since 2014. DCA is a special device to remove the atherosclerotic plaque of coronary artery in percutaneous coronary intervention (PCI). However, DCA procedure is recommended to perform by 8Fr system, which is one of the limitations of DCA. Case Series: Since transradial approach is the main access route for PCI, we considered how to perform DCA by TRA. The external diameter of 8Fr guiding catheter (GC) and 6Fr sheath are 2.70 and 2.67 mm. Then, if 6Fr sheath can be inserted without any resistance, 8Fr GC is considered to be insertable. We performed 5 cases of DCA by the transradial 8Fr sheathless GC approach, all cases were successful without discomfort associated with insertion and removal of the 8Fr GC. Conclusion: DCA by the transradial 8Fr sheathless GC approach might be one of options to avoid bleeding complication and serve more comfortable treatment for the patients.

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“…The access failure rate is lower in trans-femoral route (2.4%) vs. trans-radial route (7.2%). 13,15 Ideally, trans-radial approach should be taken after performing Allen's test but in daily routine most of the interventional cardiologist take this route just palpating the pulse and assessing the volume of radial artery. An older study conducted by this method on 100 consecutive patients in which their mean age was 53 years and success rate was more than 95%.…”

Section: Discussionmentioning

confidence: 99%

Outcomes of Transradial Approach in Terms of Procedural Failure, in Patients Undergoing Percutaneous Coronary Intervention

Idbaïh¹,

Balouch²,

Raza³

et al. 2022

PJMHS

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Objective: To evaluate the outcomes of transradial approach in terms of procedural failure in patients undergoing percutaneous coronary intervention. Methods: We have enrolled a total of 276 patients who consented for percutaneous coronary intervention through trans-radial approach at National Institute of Cardiovascular diseases, Karachi. Baseline and clinical data were collected in a structured questionnaire. Patients were assessed at the end of completion of PCI for the achievement of TIMI grade 3 flow by angiography under the supervision of experienced consultant having >5 years' experience of intervention. All the data entered and analysed using SPSS version 22.0. Results: Overall mean age of study subjects was 44.86±12.22 years, with range of 52 (18-70) years and among them 194 (70.28%) were males and 82 (29.71%) were females. The overall mean fluoro time was 10.95±4.83 minutes, with range of 22.1 (3.4-25.5) minutes. Our study's findings have shown no significant association of procedure failure was found with respect to gender, age, CRF, smoking, and obesity, p value <0.05. Significant association of procedure failure was observed in patients with hypertension, diabetes mellitus, family history of ischemic heart disease, hyperlipidemia and fluoro time >10 minutes. Conclusion: Transradial approach becomes the primary choice of vascular access for PCI. The transradial approach eliminates access site complications after PCI. Thus, patients discharge from hospital within 48 hours post-procedure and can mobilize within few hours post-procedure.

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The efficacy and safety of transradial and transfemoral approach in treatment of coronary chronic total occlusion: a systematic review and meta-analysis

Cited by 10 publications

References 29 publications

Transradial Uterine Artery Embolization Complicated by Stroke

Transradial Uterine Artery Embolization Complicated by Stroke

Usefulness of the Transradial 8Fr Sheathless Guiding Catheter Approach in Directional Coronary Atherectomy

Outcomes of Transradial Approach in Terms of Procedural Failure, in Patients Undergoing Percutaneous Coronary Intervention

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