Abstract
Since the introduction of transradial coronary intervention (TRI) by Kiemeneij, its advantages over transfemoral coronary intervention (TFI) have been shown in many clinical situations. TRI can reduce the incidence and severity in the bleeding complications through arterial access site [1], which result in the reduction in mortality, length of hospital stay and cost after percutaneous coronary intervention (PCI). Since TRI is more patients’ friendly, most of the patients, who have received both TRI and TFI, prefer to the former from next session.
The major disadvantage of TRI is its limitation in the size of guiding catheter due to the smaller diameter of radial compared to femoral arteries. The distribution of radial artery diameter in Japanese patient population has been reported [2]. This limitation first results in the reduced backup support achieved by the guiding catheters. Secondly, it limits the use of several devices or the simultaneous use of several devices. This, in turn, limits the use of several techniques, which have been developed in angioplasty for chronic total occlusion (CTO) lesions.
In this chapter, various techniques for CTO angioplasty will be first described. Then, the feasibilities in their application in TRI will be discussed.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
References
Saito S, Miyake S, Hosokawa G, Tanaka S, Kawamitsu K, Kaneda H, Ikei H, Shiono T. Transradial coronary intervention in Japanese patients. Catheter Cardiovasc Interv. 1999;46:37–41.
Saito S, Ikei H, Hosokawa G, Tanaka S. Influence of the ratio between radial artery inner diameter and sheath outer diameter on radial artery flow after transradial coronary intervention. Catheter Cardiovasc Interv. 1999;46:173–8.
Saito S, Tanaka S, Hiroe Y, Miyashita Y, Takahashi S, Satake S, Tanaka K. Angioplasty for chronic total occlusion by using tapered-tip guidewires. Catheter Cardiovasc Interv. 2003;59:305–11.
Katsuragawa M, Fujiwara H, Miyamae M, Sasayama S. Histologic studies in percutaneous transluminal coronary angioplasty for chronic total occlusion: comparison of tapering and abrupt types of occlusion and short and long occluded segments. J Am Coll Cardiol. 1993;21:604–11.
Kaneda H, Saito S, Shiono T, Miyashita Y, Takahashi S, Domae H. Sixty-four-slice computed tomography-facilitated percutaneous coronary intervention for chronic total occlusion. Int J Cardiol. 2007;115:130–2.
Hirokami M, Saito S, Muto H. Anchoring technique to improve guiding catheter support in coronary angioplasty of chronic total occlusions. Catheter Cardiovasc Interv. 2006;67:366–71.
Fujita S, Tamai H, Kyo E, Kosuga K, Hata T, Okada M, Nakamura T, Tsuji T, Takeda S, Bin Hu F, Masunaga N, Motohara S, Uehata H. New technique for superior guiding catheter support during advancement of a balloon in coronary angioplasty: the anchor technique. Catheter Cardiovasc Interv. 2003;59:482–8.
Takahashi S, Saito S, et al. New method to increase a backup support of a 6 French guiding coronary catheter. Catheter Cardiovasc Interv. 2004;63:452–6.
Takeshita S, Shishido K, Sugitatsu K, Okamura N, Mizuno S, Yaginuma K, Suenaga H, Tanaka Y, Matsumi J, Takahashi S, Saito S. In vitro and human studies of a 4F double-coaxial technique (“mother-child” configuration) to facilitate stent implantation in resistant coronary vessels. Circ Cardiovasc Interv. 2011;4:155–61.
Shishido K, Takeshita S, Tanaka Y, Saito S. The 4 Fr mother-child technique with side-branch protection for treatment of complex bifurcation lesions. EuroIntervention. 2012;8:634–7.
Saito S. Open Sesame Technique for chronic total occlusion. Catheter Cardiovasc Interv. 2010;75:690–4.
Saito S. Different strategies of retrograde approach in coronary angioplasty for chronic total occlusion. Catheter Cardiovasc Interv. 2008;71:8–19.
Kaneda H, Takahashi S, Saito S. Successful coronary intervention for chronic total occlusion in an anomalous right coronary artery using the retrograde approach via a collateral vessel. J Invasive Cardiol. 2007;19:E1–4.
Taketani Y, Kaneda H, Saito S. Successful coronary intervention for chronic total occlusion using a retrograde approach with biradial arteries. J Invasive Cardiol. 2007;19:E281–4.
Matsumi J, Adachi K, Saito S. A unique complication of the retrograde approach in angioplasty for chronic total occlusion of the coronary artery. Catheter Cardiovasc Interv. 2008;72:371–8.
Matsubara T, Murata A, et al. IVUS-guided wiring technique: promising approach for the chronic total occlusion. Catheter Cardiovasc Interv. 2004;61(3):81–6.
Matsumi J, Saito S. Progress in the retrograde approach for chronic total coronary artery occlusion: a case with successful angioplasty using CART and reverse-anchoring techniques 3 years after failed PCI via a retrograde approach. Catheter Cardiovasc Interv. 2008;71:810–4.
Tanaka Y, Takeshita S, Takahashi S, Matsumi J, Mizuno S, Yamanaka F, Sugitatsu K, Nomura Y, Imori Y, Shishido K, Tobita K, Saito S. Comparison of short- and long-term outcomes of percutaneous coronary intervention for chronic total occlusions between patients aged ≥75 years and those aged <75 years. Am J Cardiol. 2013;112:761–6.
Author information
Authors and Affiliations
Corresponding author
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2017 Springer Science+Business Media Dordrecht
About this chapter
Cite this chapter
Saito, S. (2017). Transradial Approach for Chronic Total Occlusion of Coronary Arteries: Its Advantages and Disadvantages. In: Zhou, Y., Kiemeneij, F., Saito, S., Liu, W. (eds) Transradial Approach for Percutaneous Interventions. Springer, Dordrecht. https://doi.org/10.1007/978-94-017-7350-8_18
Download citation
DOI: https://doi.org/10.1007/978-94-017-7350-8_18
Published:
Publisher Name: Springer, Dordrecht
Print ISBN: 978-94-017-7349-2
Online ISBN: 978-94-017-7350-8
eBook Packages: MedicineMedicine (R0)