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Transradial Versus Transfemoral Access for Bifurcation Percutaneous Coronary Intervention Using Second-Generation Drug-Eluting Stent

 Jung-Hee Lee  ;  Young Jin Youn  ;  Ho Sung Jeon  ;  Jun-Won Lee  ;  Sung Gyun Ahn  ;  Junghan Yoon  ;  Hyeon-Cheol Gwon  ;  Young Bin Song  ;  Ki Hong Choi  ;  Hyo-Soo Kim  ;  Woo Jung Chun  ;  Seung-Ho Hur  ;  Chang-Wook Nam  ;  Yun-Kyeong Cho  ;  Seung Hwan Han  ;  Seung-Woon Rha  ;  In-Ho Chae  ;  Jin-Ok Jeong  ;  Jung Ho Heo  ;  Do-Sun Lim  ;  Jong-Seon Park  ;  Myeong-Ki Hong  ;  Joon-Hyung Doh  ;  Kwang Soo Cha  ;  Doo-Il Kim  ;  Sang Yeub Lee  ;  Kiyuk Chang  ;  Byung-Hee Hwang  ;  So-Yeon Choi  ;  Myung Ho Jeong  ;  Hyun-Jong Lee 
 JOURNAL OF KOREAN MEDICAL SCIENCE, Vol.39(10) : e111, 2024-03 
Journal Title
Issue Date
Coronary Artery Disease* / etiology ; Coronary Artery Disease* / surgery ; Drug-Eluting Stents* ; Humans ; Percutaneous Coronary Intervention* / adverse effects ; Radial Artery ; Retrospective Studies ; Risk Factors ; Treatment Outcome
Bifurcation ; Drug-Eluting Stent ; Percutaneous Coronary Intervention ; Transradial Approach
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 secondgeneration 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.
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1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
Yonsei Authors
Hong, Myeong Ki(홍명기) ORCID logo https://orcid.org/0000-0002-2090-2031
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