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Xu Y, Li Y, Shen H, Zhang B, Zhao Q, Cheng Y, Zhao Z, Guo Q, Yang J, Zhou Y. Clinical effectiveness and radial artery remodeling assessment via very-high-frequency ultrasound/ultra biomicroscopy after applying slender 7Fr sheath for transradial approach in left main bifurcation disease. Curr Med Res Opin 2020; 36:1643-1652. [PMID: 32847430 DOI: 10.1080/03007995.2020.1815684] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
OBJECTIVE To explore the clinical effect and radial remodeling of transradial slender 7 Fr sheath for left main bifurcation disease (LM bifurcation). METHODS From January 2018 to September 2019, 236 patients with LM bifurcation undergoing transradial percutaneous coronary intervention (PCI) from two heart centers were divided into slender 7 Fr sheath group (n = 127) and 6 Fr sheath group (n = 109). Quantitative coronary angiography (QCA) and very high-frequency ultrasound/ultra biomicroscopy (VHFUBM) were used to assess the clinical effect and radial remodeling of transradial sheath. RESULTS Slender 7 Fr sheath group had a higher preoperative distal bifurcation angle (67.271 ± 22.886) than 6 Fr group (55.831 ± 20.245) (p < .05). Post-PCI QCA results showed significant differences in minimum lumen diameter at proximal left anterior descending artery (LAD) and left circumflex artery (LCX) between two groups (p < .05). There were no significant differences in target vessel myocardial infarction, target vessel revascularization, death and major adverse cardiocerebrovascular events (MACCE) at 30-day and 1-year follow-up between two groups (p>.05). No significant differences were observed in radial artery diameter (RAD), intimal-medial thickness (IMT) and radial artery injury at 24-h and 90-day follow-up between two groups. CONCLUSION With larger main and side branch diameter, larger angle of bifurcation and higher SYNTAX score, transradial slender 7 Fr sheath obtained similar clinical effects as 6 Fr sheath without increasing the occurrence of adverse events. Similar follow-up RAD, IMT and radial artery injury were observed. Therefore, slender 7 Fr sheath has safety and feasibility in applying to transradial LM-Bifurcation PCI.
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Affiliation(s)
- Yingkai Xu
- Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
| | - Yingkai Li
- Departments of Cardiology and Clinical Laboratory, Cangzhou Teaching Hospital of Tianjin Medical University, Cangzhou Central Hospital, Cangzhou, Hebei, China
| | - Hua Shen
- Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
| | - Beibei Zhang
- Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
| | - Qi Zhao
- Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
| | - Yujing Cheng
- Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
| | - Ziwei Zhao
- Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
| | - Qianyun Guo
- Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
| | - Jiaqi Yang
- Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
| | - Yujie Zhou
- Department of Cardiology, Beijing Anzhen Hospital, Beijing Institute of Heart Lung and Blood Vessel Disease, Capital Medical University, Beijing, China
- Beijing Key Laboratory of Precision Medicine of Coronary Atherosclerotic Disease, Clinical Center for Coronary Heart Disease, Capital Medical University, Beijing, China
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de la Torre Hernandez JM, Garcia Camarero T, Baz Alonso JA, Gómez-Hospital JA, Veiga Fernandez G, Lee Hwang DH, Sainz Laso F, Sánchez-Recalde Á, Perez de Prado A, Lozano Martínez-Luengas I, Hernandez Hernandez F, Gonzalez Lizarbe S, Gutierrez Alonso L, Zueco J, Alfonso F. Outcomes of predefined optimisation criteria for intravascular ultrasound guidance of left main stenting. EUROINTERVENTION 2020; 16:210-217. [DOI: 10.4244/eij-d-19-01057] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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