Transradial and slender percutaneous coronary intervention: less invasive strategy in PCI

Abstract

Although there is a discussion on the outcome between percutaneous coronary intervention (PCI) and bypass surgery, PCI is clearly superior to bypass surgery in terms of less invasiveness. One of the further less invasive strategy is transradial approach (TRI). There have been several limitations such as low backup force of guiding catheters. However, mechanics studies showed that the backup force does not relate to approach site but to catheter shape and size. The other strategy is slender PCI using a 5 Fr or less guiding catheter. The slender PCI has also several limitations, however, some of these limitations have been overcome using new slender devices and new slender specific techniques. In this article, current progress in this field using new devices is reviewed. The less invasive strategy such as TRI and slender PCI may be the future direction of PCI because they prevent complications and improve quality of life.

Transradial intervention for patients with ST elevation myocardial infarction with or without cardiogenic shock

“…Several reports have suggested the advantages of TRI for STEMI in terms of both reduction in site complications and lower reinfarction or mortality rates . To the contrary, several limitations in TRI have been reported such as longer door to balloon time and relatively high cross‐over rate of approach site .…”

Prognostic Value of Ankle–Brachial Index in Patients Undergoing Percutaneous Coronary Intervention: In-Hospital and 1-Year Outcomes From the SHINANO Registry

“…In recent years, PCI has become safer and less invasive owing to the development of devices and approaches, such as the trans-radial approach and slender PCI. 8,9 Although drug-eluting stents (DES) markedly reduce the rates of target-lesion revascularization, 10 the safety of discontinuing dual antiplatelet therapy remains controversial in terms of late or very late stent thrombosis even after the advent of second-generation DES. 11 In fact, more than half of the patients with PAD have concomitant CAD.…”

A novel percutaneous coronary intervention technique for chronic total occlusion: Contralateral angiography with a single guiding catheter

“…This not only reduces injury to the radial artery but there is also an economic effect with shorter hospital stay and a GC is employed, which is small in diameter . In today's age, the advantage of using a slender GC in TRI is understood and such evidence is accumulating . With such historical background, the new technique we developed has the potential of application in a wide range of cases.…”