Transradial intervention via large-bore guide catheters: A study of coronary bifurcation disease treatment using the crush technique

Transradial access for coronary intervention significantly reduces vascular complications and may be associated with a reduced risk of major adverse cardiovascular events. However, the small caliber of the radial artery has been considered a limitation to performing complex coronary intervention. Fifty-three patients with true bifurcation disease, in whom a two-stent strategy was felt to be indicated, were scheduled to undergo crush stenting via the transradial approach. Procedural outcome was recorded and 6- and 18-month clinical follow-up was performed. Successful crush stenting via the radial artery was performed in 51/55 lesions (93%). Crush stenting was performed in 53 lesions overall and successful final kissing inflation was achieved in 51/53 (96%). There were no in-hospital or procedural complications. The overall rate of death, myocardial infarction, or target vessel revascularization was 9.8% at 18-month follow-up. Complex percutaneous coronary intervention requiring large-bore catheters can be performed successfully in a high proportion of patients via the transradial approach. Crush stenting, with a very high rate of final kissing inflation, was associated in this series with excellent procedural and medium-term outcomes.