Transradial Intervention Treatment Of Coronary Bifurcation Lesions In Clinical Studies

Objective:To investigate the feasibility and safety of percutaneous radial artery approach for angioplasty in patients with coronary bifurcation lesions by transradial and transfemoral approaches.Methods:A total of 137 patients with bifurcation lesions underwent percutaneous coronary intevention(PCI)in our hospital from May 2005 to December 2009 were studied. The patients were divided into two groups. Transfemoral intervention (TFI) group, n=72, and Transradial intervention (TRI) group, n=65. The success rate of the procedure, including the procedural time, amount of contrast and the vascular complications between two groups were compared during 12 months follow up time were observed.Results:Processing data with SPSS 13.0, the measurement data was presented with±standard deviation, enumeration data was presented with frequency. The compare between the group of measurement data use completely random T Test. The compare between the groups of enumeration data use x2 Test or Fisher's exact probabilistic method. In the aspect of clinic character, the two groups have the similar ages. Both clinical characteristics and coronary lesion feamres between the two groups were similar. The procedure success rate were both 100% in TRI group and TFI group. In TRI group 6F guiding catheter was used in majority of patients (92.3%) and in TFI group (25%)(P<0.001), while 7F guiding catheter was more frequently used in TFI group (75%) and in TRI group (7.7%) (P<0.001), the success rate of transradial and transfemoral procedures had significant difference. In TRI Balloon Crush technology was used in majority of patients (21.5%) and in TFI group (2.7%) (P=0.001), while standard Crush technology was more frequently used in TFI group (29.2%) and in TRI group (3.1%), the success rate of transradial and transfemoral procedures had significant difference. Compare the difference of final kissing balloon post-dilatation, operatin time, X ray exposure time, the dosage of contrast media, the two groups had no significant difference. In the aspect of complication,1 patient in TRI group appear radial artery blocking. Then 6 patients in TFI group appear vessel complication, including 3 arteria cruralis hematoncus,1 pseudoaneurysm,1 arteriovenous fistula, 1 retroperitoneal hemorrhage. Though there was no significant difference, the complication in TRI group (1.5%) was less than in TFI group (8.3%). In 12 months follow-up visit,1 patient was dead in TRI group,1 patient appear myocardial infarction.1 patient was dead in TFI group, but 2 patient appear myocardial infarction. The incidence of MACE was similar in both groups.Conclusion:The clinical characteristics between the two groups were similar, both of the two group have success rate, less vessel complication, less pain, and patients need no lie in bed after operation. Then Transradial intervention was feasible and appeared to be effective and safe in the treatment.