Feasibility of single catheter intervention for multivessel coronary artery disease using transradial approach

Abstract

Objective: The objective of the study was to describe the feasibility of single catheter intervention using the transradial approach for percutaneous coronary intervention (PCI). Background: The transradial approach for PCIs has fewer vascular events and complications and lower mortality rate. However, complications can result from forearm artery tortuosity, a longer learning curve and artery spasm that can complicate, delay and impede coronary artery interventions. The latter is usually exacerbated by the changing and manipulation of catheters. Methods: We performed a study using a single catheter on patients undergoing coronary assessment and treatment. Procedural outcomes including success, procedural time, bleeding, access site complications, and contrast used were all analyzed. Results: We included 327patients, of whom 70% were male. The mean age was 63.3 ± 11.1 years, mean height was 165.9 ± 7.7 cm, mean weight was 73.3 ± 11.3 kg, and mean body index was 26.5 ± 3.5 kg/m2. Contrast use averaged 158.5 ± 60.5 ml. Three vessels were treated in 3% of all cases, two vessels in 32%, and one vessel in 65%. Procedural success was achieved in 94.5% of the cases. A second catheter was required in 9 cases (2.7%), and crossover to the femoral approach was performed in 9 cases (2.7%) due to a lack of support, artery spasm, difficult anatomy, or the need for a larger catheter. Three complications were related to access, including a Class 2 hematoma that was treated conservatively with no further complications. Conclusions: Our study showed that using a single catheter to perform both diagnostic and therapeutic procedures has a higher success rate, lower spasm incidence, and fewer complications than reported in literature.