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The Transradial Approach for Bifurcation Lesions

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Abstract

The history of transradial approach for cardiac catheterism begins before the one of transfemoral approach. The technique is adapted in 1992 for PCI by Kiemeneij. Since that time this approach is proved to be superior to femoral approach regarding the risk of vascular complications, more comfortable for the patient, perfectly adapted to outpatient diagnosis and coronary intervention. A reduction of procedural related mortality has been found speciallyin acute coronary syndroms situations. The transradial approach has been adapted to most clinical, angiographical and technical subsets for PCI. Transradial approach for coronary diagnosis and intervention are related to anatomy, like some anatomical variations and small size of the vessel. For the treatment of coronary bifurcation lesions the only one specific limitation is the necessity of 6F guiding catheter (it can be a sheathless one), and for only one technique a 7F (the Simultaneous Kissing Stent). Acornary bifurcation is an anatomic and physiologic entity dedicated to flow flow distribution, with 3 segments, Proximal Main, Distal Main and Side Branch, and 3 different diameter.In non left main bifurcation the provisional side branch stenting strategy is the most frequently used after multiple randomized comparison with techniques begining with side branch stenting (inverted Culotte, DK Crush Transradial approach can be used also to treat distal left main stenosis using the same techniques, without any randomized comparative trial published.

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  1. Institut Cardiovasculaire Paris Sud (ICPS), Hôpital Privé Jacques Cartier, Générale de Santé, Massy, France

    Yves Louvard & Thierry Lefevre

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  1. Yves Louvard
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  2. Thierry Lefevre
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Correspondence to Yves Louvard .

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Editors and Affiliations

  1. Beijing, China

    Yujie Zhou

  2. Amsterdam, The Netherlands

    Ferdinand Kiemeneij

  3. Kanagawa, Japan

    Shigeru Saito

  4. Beijing Anzhen Hospital, Beijing, China

    Wei Liu

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Louvard, Y., Lefevre, T. (2017). The Transradial Approach for Bifurcation Lesions. 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_16

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