Zhongguo quanke yixue (Sep 2023)
Feasibility, Safety and Timing of Secondary Percutaneous Coronary Intervention via Distal Transradial Artery Approach
Abstract
Background Percutaneous coronary intervention (PCI) via distal transradial artery approach (dTRA) is effective in reducing the incidence of radial artery occlusion, however, there are no reports on the feasibility, safety and timing of secondary PCI via dTRA domestically. Objective To explore the feasibility, safety and timing of secondary PCI via dTRA. Methods A total of 70 patients who were to undergo secondary PCI via dTRA in Fuwai Hospital, CAMS&PUMC from July 2021 to July 2022 were consecutively included and divided into ≤30 d group (n=33) and >30 d group (n=37) according to the time interval since the last PCI via dTRA. The general clinical data, operation-related indicators, coronary artery lesions and radial artery inner diameters at 5, 10 and 15 cm proximal to the radial styloid process before and 24 h after PCI were compared between the two groups. Results The dTRA puncture and catheterization were successfully conducted in 69 of 70 patients, with a success rate of 98.6% (69/70) . Second PCI via dTRA was successfully completed in 66 of 67 patients assessed for secondary PCI, with a success rate of 98.5% (66/67) . There were significantly difference in age, platelet count, incidence of diabetes, number of lesioned vessels and ACC/AHA coronary artery lesions typing (P<0.05) . The compression bandage was released 3 hafter surgery, and the radial artery pulsation on the puncture side was palpable immediately and 24 h after surgery, and none of the patients occurred radial artery occlusion, with the radial artery patency rate of 100.0% (69/69) . The radial artery inner diameters at 5, 10 and 15 cm proximal to the radial styloid process in ≤30 d group were significantly greater than that in >30 d group before and 24 h after PCI when comparing between the two groups, respectively (P<0.05) . Radial artery inner diameter at 15 cm proximal to the radial styloid process 24 h after PCI was smaller than that before surgery in ≤30 d group, radial artery inner diameter at 5 cm proximal to the radial styloid process 24 h after PCI was smaller than that before surgery in >30 d group (P<0.05) . Conclusion Secondary PCI via dTRA is safe and feasible independent of first dTRA PCI time (≤30 days or >30 days from the first dTRA PCI) , and the timing of secondary PCI via dTRA should be determined according to the patient's condition and puncture site.
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