Transradial versus tibiopedal access approach for endovascular intervention of superficial femoral artery chronic total occlusion

Autor: Apurva Patel, Myo Maw, Zoltán Ruzsa, Tak W. Kwan, Joseph Puma, John Coppola, WahWah Htun, Robert Bellavics, Roosha Parikh, Olivier F. Bertrand
Rok vydání: 2018
Předmět:
Male
medicine.medical_specialty
Time Factors
medicine.medical_treatment
Target vessel revascularization
Constriction
Pathologic
030204 cardiovascular system & hematology
Total occlusion
Amputation
Surgical
030218 nuclear medicine & medical imaging
03 medical and health sciences
Peripheral Arterial Disease
0302 clinical medicine
Text mining
Risk Factors
Catheterization
Peripheral
medicine
Clinical endpoint
Humans
Radiology
Nuclear Medicine and imaging
Adverse effect
Aged
Aged
80 and over
Hungary
business.industry
Superficial femoral artery
Endovascular Procedures
General Medicine
Middle Aged
Limb Salvage
Surgery
Femoral Artery
Tibial Arteries
medicine.anatomical_structure
Treatment Outcome
Amputation
Chronic Disease
Radial Artery
Feasibility Studies
Female
New York City
Cardiology and Cardiovascular Medicine
business
Artery
Zdroj: Catheterization and cardiovascular interventions : official journal of the Society for Cardiac AngiographyInterventions. 92(7)
ISSN: 1522-726X
Popis: Background Improved equipment and techniques have resulted in transition from surgical bypass to endovascular intervention to treat superficial femoral artery (SFA) chronic total occlusions (CTO). A change in access site to radial (TRA) or tibiopedal (TPA) artery for the treatment of these SFA CTO has been reported. The feasibility, efficacy and safety of these two access sites for treatment of SFA CTO have not been reported. Methods We performed an as treated analysis of 184 SFA CTO interventions in 161 patients from 01/2014 to 09/2016 using either primary TRA or TPA (operator discretion) at two institutions. Primary end point was 30 day major adverse event (MAE) - death, amputation or target vessel revascularization, secondary endpoint was success of procedure. Results Primary TRA was used in 46 patients with 47 CTO lesions .Primary TPA was used in 115 patients with 137 CTO lesions. Primary crossing success rate was higher with TRA compared to TPA (74% vs 54%, P = 0.01). Dual TRA-TPA was required in 72 prior uncrossed lesions resulting in a crossing and procedural success of 99% and 96% respectively. The overall crossing and procedural success rate using either of these approaches was 99% and 98% respectively. The 30 day MAE was 5% in TRA arm, 0% in TPA arm and 2% in dual TRA-TPA arm, P = 0.08. All access sites were patent, confirmed by ultrasound. Conclusion The treatment of SFA CTO is feasible and safe using both TRA or TPA approach providing high success rates and no access site complications.
Databáze: OpenAIRE
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