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Bilateral Distal Transradial Access for Chronic Total Occlusion Recanalization and Multivessel Coronary Disease Percutaneous Intervention

02 May 2021

Chronic total occlusion (CTO) represents the most challenging setting for percutaneous coronary intervention (PCI) and multivessel coronary disease (MCD) is often treated in a staggered manner and in a deferred procedure. Although transfemoral is one of the common access site, the transradial access (TRA) has been used with similar procedural success.

The distal transradial access (dTRA) as default approach for coronary angiography (CAG) and interventions is also used in Latin America. This technique has many advantages in terms of enhancing patient comfort, reducing access-site bleeding, faster hemostasis, and diminishing radial artery occlusion.

Although dTRA has shown clinical advantages, when performing dTRA in CTO cases, there are concerns about its safety and efficacy because of higher procedure complexity and the need for strong guide catheter support [1]. In such case, thin-wall sheath with good kink resistance and large inner lumen would be crucial to perform CTO cases via dTRA access.

A clinical case is presented with a bilateral distal radial approach and successful treatment of chronic coronary occlusion through APT Medical thin-walled 7 Fr hydrophilic introducers by Dr. Héctor H. Escutia.

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