The Feasibility of 5-French Transradial Coronary Intervention, as Compared with a 6-French Approach, for Treating Chronic Total Occlusion

Background and Objectives:Recent studies have shown that transradial coronary intervention (TRI) is feasible for percutaneous revascularization of chronic total occlusion (CTO). We investigated the feasibility and safety of using a 5-French catheter (5F) TRI for CTO and we compared it with that of using a 6F catheter TRI. Subjects and Methods:One hundred fifteen patients (117 lesions) who underwent TRI for CTO (TIMI 0 or 1 for more than 2 months) were prospectively registered in this study from April 2002 to July 2004 (54 patients for the 5F and 61 patients for the 6F). The clinical, angiographic and procedural characteristics were evaluated and compared between the 2 groups. Results:No major difference was noted for the clinical characteristics between the 2 groups. Coronary angiography showed a shorter occlusion length (5F: 8.8±7.6 mm, 6F: 14.7±12.7, p=0.008) and a higher incidence of the tapered type of entry morphology (5F: 74%, 6F: 56%, p=0.042) in the 5F group. A deepseating technique was used more often in the 5F group (5F: 83%, 6F: 51%, p<0.001). The procedural success rate was similar between the 2 groups (5F: 82%, 6F: 86%, p<0.54). The most common cause of procedural failure for both groups was failure to pass the guidewire. The occlusion duration, lesion length and lesion angulation were the statistically significant predictors of procedural failure. No major procedural or local complication was noted. Minor hematoma occurred in 2 patients and no radial artery occlusion was noted. Conclusion:A 5F catheter TRI may be feasible and safe to use for a selected group of CTO lesions. (Korean Circulation J 2007;37:298-303)