Balloon-assisted tracking technique as ‘a way forward’ for transradial intervention

Wojciuk, Jerzy; Beijk, Marcel A.M.; Goode, Grahame K.; Brack, M. J.; Galasko, Gavin; More, Ranjit; Roberts, David K.; Eichhöfer, Jonas; Patel, Billal; Chauhan, Anoop; Wiper, Andrew

doi:10.1097/mca.0000000000000772

Cited by 6 publications

(8 citation statements)

References 40 publications

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“…Other implications concerning vascular access in patients treated with RA were discussed more widely in the previous publication [18]. These include, inter alia, puncture of arteries under ultrasound control, the use of guiding catheters with hydrophilic sheaths, so-called sheathless guiding catheters, and the so-called balloon-assisted tracking, which allows the passage of diagnostic and rescue catheters through often narrow and tortuous vessels, which further facilitates the maintenance of radial access and avoiding conversion to, for example, femoral access [24][25][26].…”

Section: Discussionmentioning

confidence: 99%

Sex-related differences and rotational atherectomy: Analysis of 5 177 percutaneous coronary interventions based on a large national registry from 2014 to 2020

Sabatowski¹,

Malinowski

Siudak

et al. 2021

Kardiol Pol

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Background: Patients undergoing percutaneous coronary interventions (PCI) with rotational atherectomy (RA) have massively calcified coronary arteries and their prognosis differs between sexes. Aims:The aim of the study was to evaluate the trends in the percentage of sexes in the subsequent years, to compare demographic characteristics between men and women, and to identify factors associated with the risk of periprocedural complications and death. Methods:We analyzed data on 751 113 patients treated with PCI between 2014 and 2020 from the Polish National Registry of Percutaneous Coronary Interventions (ORPKI). We extracted data on 5 177 (0.7%) patients treated with RA of whom 3 552 (68.6%) were men. To determine risk factors of periprocedural complications and death, a multivariable analysis was performed. Results:The proportion of PCIs involving RA increased between 2014 and 2020 (P <0.001). Almost twice as many RA procedures were performed on men (68.55%), and that proportion did not change in the following years. The female patients were older (75.2 [8.3] vs. 70.5 [9.2] years; P <0.001). When considering periprocedural complications, their overall rate (3.45% vs. 2.31%; P = 0.01) and death rate (0.68% vs. 0.17%; P = 0.006) were greater among women. Also, via multivariable analysis, female sex was found to be a risk factor for greater periprocedural mortality (P = 0.02) and overall complication rate (P = 0.007). 1321 Karol Sabatowski et al., Rotational atherectomy and sex w w w . j o u r n a l s . v i a m e d i c a . p l / k a r d i o l o g i a _ p o l s k a W H a t ' S n e W ?Female sex is associated with poorer clinical outcomes after percutaneous coronary interventions (Pcis) including a higher risk of death, myocardial infarction or target vessel failure, and lesion failure in long-term follow-up. Patients undergoing Pci with rotational atherectomy (ra) have massively calcified coronary arteries and differ according to sex. We aimed to assess the trends in the percentage of sexes in the years 2014-2020, to compare demographic characteristics between men and women and to identify factors associated with the risk of periprocedural complications and death. Out of 751 113 patients treated with Pci between 2014 and 2020, we extracted data on 5 177 (0.7%) patients treated with ra of whom 3 552 (68.6%) were men. Sex-related distribution of patients treated with ra was stable during the analyzed period. Multivariable regression analysis confirmed that female sex is a risk factor of periprocedural complications and mortality in patients treated with Pci and ra.

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Section: Discussionmentioning

confidence: 99%

Sex-related differences and rotational atherectomy: Analysis of 5 177 percutaneous coronary interventions based on a large national registry from 2014 to 2020

Sabatowski¹,

Malinowski

Siudak

et al. 2021

Kardiol Pol

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“…In this study, the balloon-assisted tracking (BAT) technique was not used to insert the imaging catheter. The BAT technique can further raise the catheter through the spasmodic radial artery and increase the success rate of coronary procedures [ 18 ].…”

Section: Discussionmentioning

confidence: 99%

Correlation of a guidewire maximum insertion length with tortuous radial artery and the success rate during transradial coronary angiography

Chen

Sha

et al. 2022

BMC Cardiovasc Disord

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Background Percutaneous coronary intervention (PCI) is a safe and effective therapy for patients with obstructive coronary artery disease (CAD). We aimed to assess the correlation between the success rate of angiography and the maximum insertion length and resistance of a soft-tipped guidewire. Methods Five hundred twenty-one patients were treated by successful radial artery puncture. According to whether the guidewire resistance, the patients were divided to three groups. 17 patients were maximum insertion length of guidewire ≤ 30 cm when resistance was encountered (group 1). 17 patients were maximum insertion length of guidewire between 30 and 45 cm when resistance was encountered (group 2). 487 patients were no resistance encountered (group 3). Results The coronary angiography success rates of group 1, 2, and 3 were 52.94%, 47.05%, 98.97%, respectively. Typically, angiography can be completed in patients with Ω-shaped, S-shape or Z-shaped tortuosity. Conclusions The maximum insertion length of straight guidewire and resistance can be used to determine radial artery status. The radial artery tortuosity or spasm significantly affects the success rate of coronary angiography.

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“…However, occurrence of distal embolization in our study was significantly higher in patients with ACS (39.1% vs. 17.9%, p = 0.043). The difference can be explained with our PTA technique in the BAO group, which was very similar to the balloon assisted technique (BAT) in cardiology, therefore, after the submaximally inflated balloon was gently traversed to the entire affected segment, then manual aspiration of atherosclerotic deposits was performed [32,33].…”

Section: Discussionmentioning

confidence: 99%

Comparing Endovascular Treatment Methods in Acute Ischemic Stroke Due to Tandem Occlusion Focusing on Clinical Aspects

Kalmar

Tarkanyi

Nagy

et al. 2021

Life

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Introduction: Acute ischemic strokes (AIS) due to tandem occlusion (TO) of intracranial anterior large vessel and concomitant extracranial internal carotid artery (EICA) are represent in 15–20% of all ischemic strokes. The endovascular treatment (EVT) strategy for those patients is still unclear. Although the intracranial mechanical thrombectomy (MT) is considered as a standard treatment approach, the EICA lesion stent necessity remains a matter of debate. We sought to assess the efficacy and safety of EVT in tandem lesions, particularly the EICA stenting management. Methods: We retrospectively analyzed all patients with anterior circulation stroke associated with EICA lesion and receiving EVT in the three participated stroke centers between November 2017 and December 2020. Patients’ data were collected from our prospective stroke registry (STAY ALIVE). Patients enrolled in our study were divided into two groups depending on whether acute carotid stenting (ACS) or balloon angioplasty only (BAO) technique was used. Our primary outcome was the 90-day functional outcome assessed by modified Rankin scale (mRS). Mortality at 90 days and symptomatic intracranial hemorrhage (sICH) were considered as secondary outcomes. Results: A total of 101 patients (age: 67 ± 10 years, 38.6% female) were enrolled in our study, including 29 (28.3%) BAO cases, and 72 (71.3%) patients treated with ACS. Patients in the BAO group were slightly older (70 ± 9 years vs. 66 ± 10 years, p = 0.054), and had higher prevalence of comorbidities such as hypertension (100.0% vs. 59.4%, p < 0.001). There was no significant difference in favorable outcomes (51.7% vs. 54.4%, p = 0.808) between the groups. However, we observed a trend towards higher rates of sICH (8.3% vs. 3.4%, p = 0.382) and 90-day mortality (23.5% vs. 13.8%, p = 0.278) with significantly higher frequency of distal embolization (39.1% vs. 17.9%, p = 0.043) in patients with ACS. In the overall population age (p = 0.013), atrial fibrillation (AF) (p = 0.008), National Institutes of Health Stroke Scale (NIHSS) baseline (p = 0.029), and successful recanalization (p = 0.023) were associated with favorable outcome. Conclusion: Endovascular approach of EICA in addition to MT was safe and effective in tandem occlusion of anterior circulation. Furthermore, our results suggest that balloon angioplasty technique without acute stenting shows a comparable favorable outcome rate to ACS with moderately less hemorrhagic events and mortality rates.

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Balloon-assisted tracking technique as ‘a way forward’ for transradial intervention

Cited by 6 publications

References 40 publications

Sex-related differences and rotational atherectomy: Analysis of 5 177 percutaneous coronary interventions based on a large national registry from 2014 to 2020

Sex-related differences and rotational atherectomy: Analysis of 5 177 percutaneous coronary interventions based on a large national registry from 2014 to 2020

Correlation of a guidewire maximum insertion length with tortuous radial artery and the success rate during transradial coronary angiography

Comparing Endovascular Treatment Methods in Acute Ischemic Stroke Due to Tandem Occlusion Focusing on Clinical Aspects

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