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. 2022 Sep;37(9):1478-1488.
doi: 10.1007/s00380-022-02053-8. Epub 2022 Mar 19.

Rotational atherectomy via the transradial access: success rates, procedural parameters and complications

Paul Ferstl  1 , Anne-Sophie Drentwett  1 , Sophie Bargon  1 , Nora Schacher  1 , Monique Tröbs  1 , Mohamed Marwan  1 , Stephan Achenbach  1 , Luise Gaede  2
Affiliations

Rotational atherectomy via the transradial access: success rates, procedural parameters and complications

Paul Ferstl et al. Heart Vessels. 2022 Sep.

Abstract

Radial access is recommended for percutaneous coronary intervention (PCI), but rotational atherectomy remains frequently performed via femoral access. Analyzing the procedural parameters, success rate and complications of rotational atherectomy, performed via radial in comparison to femoral access. We retrospectively analyzed 427 consecutive patients undergoing rotational atherectomy. Procedural parameters and outcome were determined in 171 patients, scheduled for radial and compared to 256 patients with femoral access use. In the radial access group (74 ± 9 years, 84% male), the LAD was most frequently treated (49%). Sheath size was 7F in 59% and 6F in 41%, burr size was 1.5 mm in 46% and 1.25 mm in 14% of patients. A temporary pacemaker was inserted in 14%. Procedural success rate stood at 97%. Access site complications occurred in 4% of patients, which was significantly less frequent than in in 256 patients treated via femoral access (13% p = 0.003). Compared to radial access, femoral access was associated with the use of larger sheaths (p < 0.001), more frequent treatment of non-LAD vessels (58.2% vs. 44.4%, p = 0.013) and a higher rate of temporary pacemaker use (27%; p = 0.001). No differences could be seen in procedural success (p = 0.83) and burr size (p = 0.51). Femoral access (OR 3.33; 95% CI 1.40-7.93), and female sex (OR3.40 95% CI 1.69-6.63) were independent predictors for access site complications. For coronary rotational atherectomy, radial access has a high success rate with overall use of smaller sheaths, but of equally sized burrs as well as a significant lower rate of access site-related complications than femoral access.

Keywords: Percutaneous coronary intervention; Radial access; Rotational atherectomy; Transradial.

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Conflict of interest statement

Luise Gaede receives advisory board fees from Boston Scientific. All other authors have no conflicts of interest.

Figures

Fig. 1
Fig. 1
Change in access site within the years 2013–2017, 2018–2019, 2020–2021
Fig. 2
Fig. 2
A Maximal sheath size in dependence of the access used in patients planned to undergo rotational atherectomy, B maximal burr sizes (mm) in dependence of the access used in patients, who underwent rotational atherectomy, C use of temporary pacemaker within the years 2013–2017, 2018–2019, 2020–2021 in patients undergoing rotational atherectomy via the radial or femoral access
See this image and copyright information in PMC

References

    1. Barbato E, Carrié D, Dardas P, Fajadet J, Gaul G, Haude M, Khashaba A, Koch K, Meyer-Gessner M, Palazuelos J, Reczuch K, Ribichini FL, Sharma S, Sipötz J, Sjögren I, Suetsch G, Szabó G, Valdés-Chávarri M, Vaquerizo B, Wijns W, Windecker S, De Belder A, Valgimigli M, Byrne RA, Colombo A, Di Mario C, Latib A, Hamm C. European expert consensus on rotational atherectomy. EuroIntervention. 2015;11:30–36. doi: 10.4244/EIJV11I1A6. - DOI - PubMed
    1. Sharma SK, Tomey MI, Teirstein PS, Kini AS, Reitman AB, Lee AC, Généreux P, Chambers JW, Grines CL, Himmelstein SI, Thompson CA, Meredith IT, Bhave A, Moses JW. North American expert review of rotational atherectomy. Circ Cardiovasc Interv. 2019;12:e007448. doi: 10.1161/CIRCINTERVENTIONS.118.007448. - DOI - PubMed
    1. Neumann FJ, Sousa-Uva M, Ahlsson A, Alfonso F, Banning AP, Benedetto U, Byrne RA, Collet JP, Falk V, Head SJ, Jüni P, Kastrati A, Koller A, Kristensen SD, Niebauer J, Richter DJ, Seferovic PM, Sibbing D, Stefanini GG, Windecker S, Yadav R, Zembala MO, Wijns W, Glineur D, Aboyans V, Achenbach S, Agewall S, Andreotti F, Barbato E, Baumbach A, Brophy J, Bueno H, Calvert PA, Capodanno D, Davierwala PM, Delgado V, Dudek D, Freemantle N, Funck-Brentano C, Gaemperli O, Gielen S, Gilard M, Gorenek B, Haasenritter J, Haude M, Ibanez B, Iung B, Jeppsson A, Katritsis D, Knuuti J, Kolh P, Leite-Moreira A, Lund LH, Maisano F, Mehilli J, Metzler B, Montalescot G, Pagano D, Petronio AS, Piepoli MF, Popescu BA, Sádaba R, Shlyakhto E, Silber S, Simpson IA, Sparv D, Tavilla G, Thiele H, Tousek P, Van Belle E, Vranckx P, Witkowski A, Zamorano JL, Roffi M. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur Heart J. 2019;40:87–165. doi: 10.1093/eurheartj/ehy394. - DOI - PubMed
    1. Watt J, Austin D, Mackay D, Nolan J, Oldroyd KG. Radial versus femoral access for rotational atherectomy: A UK observational study of 8622 patients. Circ Cardiovasc Interv. 2017;10:e005311. doi: 10.1161/CIRCINTERVENTIONS.117.005311. - DOI - PubMed
    1. Januszek RL, Siudak Z, Malinowski KP, Reczuch K, Dobrzycki S, Lesiak M, Hawranek M, Gil RJ, Witkowski A, Wojakowski W, Lekston A, Gasior M, Wanha W, Dudek D, Bartus S. Radial versus femoral access in patients treated with percutaneous coronary intervention and rotational atherectomy. Kardiol Pol. 2020;78:529–536. doi: 10.33963/KP.15286. - DOI - PubMed

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