Transradial Approach for Chronic Total Occlusion of Coronary Arteries: Its Advantages and Disadvantages
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 , 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 . 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.
KeywordsPercutaneous Coronary Intervention Side Branch False Lumen Chronic Total Occlusion True Lumen
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