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Transradial Versus Transfemoral Access for Bifurcation Percutaneous Coronary Intervention Using Second-Generation Drug-Eluting Stent

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Author(s)
Jung-Hee LeeYoung Jin YounHo Sung JeonJun-Won LeeSung Gyun AhnJunghan YoonHyeon-Cheol GwonYoung Bin SongKi Hong ChoiHyo-Soo KimWoo Jung ChunSeung-Ho HurChang-Wook NamYun-Kyeong ChoSeung Hwan HanSeung-Woon RhaIn-Ho ChaeJin-Ok JeongJung Ho HeoDo-Sun LimJong-Seon ParkMyeong-Ki HongJoon-Hyung DohKwang Soo ChaDoo-Il KimSang Yeub LeeKiyuk ChangByung-Hee HwangSo-Yeon ChoiMyung Ho JeongHyun-Jong Lee
Keimyung Author(s)
Hur, Seung HoNam, Chang WookCho, Yun Kyeong
Department
Dept. of Internal Medicine (내과학)
Journal Title
J Korean Med Sci
Issued Date
2024
Volume
39
Issue
10
Keyword
Transradial ApproachBifurcationPercutaneous Coronary InterventionDrug-Eluting Stent
Abstract
Background:
The benefits of transradial access (TRA) over transfemoral access (TFA) for bifurcation percutaneous coronary intervention (PCI) are uncertain because of the limited availability of device selection. This study aimed to compare the procedural differences and the in-hospital and long-term outcomes of TRA and TFA for bifurcation PCI using second-generation drug-eluting stents (DESs).

Methods:
Based on data from the Coronary Bifurcation Stenting Registry III, a retrospective registry of 2,648 patients undergoing bifurcation PCI with second-generation DES from 21 centers in South Korea, patients were categorized into the TRA group (n = 1,507) or the TFA group (n = 1,141). After propensity score matching (PSM), procedural differences, in-hospital outcomes, and device-oriented composite outcomes (DOCOs; a composite of cardiac death, target vessel-related myocardial infarction, and target lesion revascularization) were compared between the two groups (772 matched patients each group).

Results:
Despite well-balanced baseline clinical and lesion characteristics after PSM, the use of the two-stent strategy (14.2% vs. 23.7%, P = 0.001) and the incidence of in-hospital adverse outcomes, primarily driven by access site complications (2.2% vs. 4.4%, P = 0.015), were significantly lower in the TRA group than in the TFA group. At the 5-year follow-up, the incidence of DOCOs was similar between the groups (6.3% vs. 7.1%, P = 0.639).

Conclusion:
The findings suggested that TRA may be safer than TFA for bifurcation PCI using second-generation DESs. Despite differences in treatment strategy, TRA was associated with similar long-term clinical outcomes as those of TFA. Therefore, TRA might be the preferred access for bifurcation PCI using second-generation DES.
Keimyung Author(s)(Kor)
허승호
남창욱
조윤경
Publisher
School of Medicine (의과대학)
Type
Article
ISSN
1598-6357
Source
https://jkms.org/search.php?where=aview&id=10.3346/jkms.2024.39.e111&code=0063JKMS&vmode=FULL
DOI
10.3346/jkms.2024.39.e111
URI
https://kumel.medlib.dsmc.or.kr/handle/2015.oak/45377
Appears in Collections:
1. School of Medicine (의과대학) > Dept. of Internal Medicine (내과학)
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