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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.Trial registration
ClinicalTrials.gov Identifier: NCT03068494.
SUBMITTER: Lee JH
PROVIDER: S-EPMC10948262 | biostudies-literature | 2024 Mar
REPOSITORIES: biostudies-literature
Lee Jung-Hee JH Youn Young Jin YJ Jeon Ho Sung HS Lee Jun-Won JW Ahn Sung Gyun SG Yoon Junghan J Gwon Hyeon-Cheol HC Song Young Bin YB Choi Ki Hong KH Kim Hyo-Soo HS Chun Woo Jung WJ Hur Seung-Ho SH Nam Chang-Wook CW Cho Yun-Kyeong YK Han Seung Hwan SH Rha Seung-Woon SW Chae In-Ho IH Jeong Jin-Ok JO Heo Jung Ho JH Lim Do-Sun DS Park Jong-Seon JS Hong Myeong-Ki MK Doh Joon-Hyung JH Cha Kwang Soo KS Kim Doo-Il DI Lee Sang Yeub SY Chang Kiyuk K Hwang Byung-Hee BH Choi So-Yeon SY Jeong Myung Ho MH Lee Hyun-Jong HJ
Journal of Korean medical science 20240318 10
<h4>Background</h4>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).<h4>Methods</h4>Based on data from the Coronary Bifurcation Stenting Registry III, a retrospectiv ...[more]