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KMID : 0191120130280030388
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Journal of Korean Medical Science
2013 Volume.28 No. 3 p.388 ~ p.395
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Trans-Radial versus Trans-Femoral Intervention for the Treatment of Coronary Bifurcations: Results from Coronary Bifurcation Stenting Registry
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Chung Seung-min
Her Sung-Ho
Song Pil-Sang
Song Young-Bin
Hahn Joo-Yong
Choi Jin-Ho
Lee Sang-Hoon
Jang Yang-Soo
Yoon Jung-Han
Tahk Seung-Jea
Park Seung-Jung
Choi Seung-Hyuk
Seung Ki-Bae
Gwon Hyeon-Cheol
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Abstract
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Trans-radial (TR) approach is increasingly recognized as an alternative to the routine use of trans-femoral (TF) approach. However, there are limited data comparing the outcomes of these two approaches for the treatment of coronary bifurcation lesions. We evaluated outcomes of TR and TF percutaneous coronary interventions (PCI) in this complex lesion. Procedural outcomes and clinical events were compared in 1,668 patients who underwent PCI for non-left main bifurcation lesions, according to the vascular approach, either TR (n = 503) or TF (n = 1,165). The primary outcome was major adverse cardiac events (MACE), including cardiac death, myocardial infarction (MI), and target lesion revascularization (TLR) in all patients and in 424 propensity-score matched pairs of patients. There were no significant differences between TR and TF approaches for procedural success in the main vessel (99.6% vs 98.6%, P = 0.08) and side branches (62.6% vs 66.7%, P = 0.11). Over a mean follow-up of 22 months, cardiac death or MI (1.8% vs 2.2%, P = 0.45), TLR (4.0% vs 5.2%, P = 0.22), and MACE (5.2% vs 7.0%, P = 0.11) did not significantly differ between TR and TF groups, respectively. These results were consistent after propensity score-matched analysis. In conclusion, TR PCI is a feasible alternative approach to conventional TF approaches for bifurcation PCI (clinicaltrials.gov number: NCT00851526).
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KEYWORD
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Bifurcation, Percutaneous Coronary Intervention, Trans-Radial Approach
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