Transradial versus transfemoral rotablation for heavily calcified coronary lesions in contemporary drug-eluting stent era  

作　　者：Wei-Hsian Yin Chin-Kun Tseng Tien-Ping Tsao Hsu-Lung Jen Wen-Pin Huang Chien-Lung Huang Jiann-Jong Wang Mason Shing Young 

机构地区：[1]Division of Cardiology, Heart Center, Cheng Hsin General Hospital, Taipei, Taiwan, China [2]Faculty of Medicine, National Yang-Ming University, Taipei, Taiwan, China [3]Institute of Clinical Medicine, National Yang-Ming University, Taipei, Taiwan, China [4]Cardiovascular Research Centre, School of Medicine, National Yang-Ming University, Taipei, Taiwan, China

出　　处：《Journal of Geriatric Cardiology》2015年第5期489-496,共8页老年心脏病学杂志（英文版）

摘　　要：Background Although radial access for drug-eluting stent （DES） combined with rotational atherectomy （RA） in patients with calcified coronary lesions may be associated with a lower risk of major bleeding complications and obtain favorable clinical results compared with femoral access, the long-term outcome data of this approach were limited in contemporary DES era. Methods ＆ Results This retrospective study sought to compare in-hospital and long-term outcomes for patients undergoing RA via the transradial （TR） and transfemoral （TF） route in 126 consecutive patients （59 radial, 67 femoral） from 2009 to 2014. TR RA procedures were performed in 44/62 （71%） by the three TR operators, compared with 15/64 （23%） by the four TF operators in the present study. Significantly smaller diameter guide catheters and burrs （1.39 ± 0.16 mm vs. 1.53 ± 0.24 mm, P = 0.001） were used in the TR group. Procedural success rates were similar in both TR and TF groups. There was a significantly less major access site bleeding complications in favor of radial artery access （2% vs. 16%, P = 0.012）. The incidence of in-hospital death or myocardial infarction was low in both groups. Although a trend of lower adverse event rate was demonstrated in the TR group compared with the TF one, no statistical significance （21% vs. 27%, P = 0.135） was detected. Conclusions Radial access, a useful alternative to femoral access for RA and DES, can be safely and successfully performed on up to 71% of the patients with heavily calcified coronary lesions needing RA by experienced TR operators.

关 键 词：Calcified lesion Drug-eluting stent Rotablation TRANSFEMORAL TRANSRADIAL 

分 类 号：S858.28[农业科学—临床兽医学] Q954.561[农业科学—兽医学]