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Coronary rotational atherectomy via transradial approach: A study using radial artery intravascular ultrasound
Author(s) -
Gioia Giuseppe,
Comito Cosimo,
Moreyra Abel E.
Publication year - 2000
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/1522-726x(200010)51:2<234::aid-ccd22>3.0.co;2-8
Subject(s) - medicine , intravascular ultrasound , atherectomy , radial artery , lumen (anatomy) , angioplasty , stent , balloon , myocardial infarction , stenosis , revascularization , percutaneous , radiology , coronary artery disease , cardiology , artery , restenosis
The use of coronary rotational atherectomy via radial artery (RA) has been limited because of the large diameter of guiding catheters. We studied the feasibility of this approach by sizing the RA by intravascular ultrasound (IVUS) and using 7 Fr (2.31 mm) guiding catheters. Seventeen transradial percutaneous transluminal coronary rotational atherectomy (PTCRA) procedures were performed in 16 patients, mean age 62 ± 12 years, for a total of 19 vessels treated. The mean RA diameter was 2.9 ± 0.36 mm and the mean reference diameter of the treated coronary vessels was 2.7 ± 0.45 mm. The mean coronary percent stenosis was 74% ± 10%, the mean minimum lumen diameter was 0.76 ± 0.35 mm, and the mean lesion length was 16 ± 19 mm. Ten vessels were treated with rotational atherectomy alone, or with adjunctive high pressure balloon angioplasty, achieving an acute lumen gain of 0.8 ± 0.4 mm ( P = 0.001). Nine arteries had stent implantation in addition to rotational atherectomy, resulting in an acute lumen gain of 2.4 ± 0.5 mm ( P = 0.001). The success rate was 94%. There were no vascular complications. Two patients had a non‐Q myocardial infarction. In conclusion, transradial PTCRA when used in conjunction with IVUS of the RA is a safe and feasible procedure in selected cases. This may be an alternative approach of revascularization technique especially for patients with limited vascular access and for those who require early ambulation or early discharge from the hospital. Cathet. Cardiovasc. Intervent. 51:234–238, 2000. © 2000 Wiley‐Liss, Inc.