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The use of the Transradial access (TR) for the treatment of Coronary Bifurcation Lesions (CBL) with Percutaneous Coronary Intervention (PCI) can be limited where a two stent strategy is required as larger sheath and guide catheters are required to facilitate stent delivery. With the development of newer dedicated bifurcation stents, there is an increasing trend of these stents to be adopted in PCI centres to treat CBL's. We report our experience of the use of the Tryton™ dedicated side branch bifurcation stent at our default TR centre where 90% of all PCI are carried out via the TR.
This was a prospective study of all patients who were found suitable to undergo PCI to CBL's using the Tryton stent between September 2009 and June 2013. Data on patient demographics and procedure characteristics was collected from the local hospital database.
36 patients (Male 69.4%, age 68.1 years) underwent PCI using the 19mm long Tryton™ bifurcation stent. Most of the CBL's treated were located in the LAD/Branch (52.8%), followed by the Circumflex/Branch (27.8%), Left main stem/Branch (13.9%), RCA/Branch (2.7%) and LIMA graft (2.7%). Tryton™ stents dimensions (Side branch/Main branch diameters) deployed were (2.5/2.5mm - 11.1%; 2.5/3.0mm - 25%; 2.5/3.5mm - 47.2%; 3.0/3.5mm - 8.3% and 3.5/4.0mm - 8.3%). 91.6% of cases were carried out via 6F guide catheters with the remaining cases carried out via the 7F. Mean contrast volume, radiation dose and fluoroscopy times were 306 mls, 98.8 Gy/cm2 and 28.2 minutes respectively. 94.4% of all cases were successfully carried out via the TR route with remaining cases switching to the transfemoral route to successfully complete the procedure.
When treating CBL's, a wide range of Tryton™ dedicated side branch stents can be safely and effectively deployed via the TR route using 6F/7F Guide catheter systems. This can avoid the use of the transfemoral route and its associated potential vascular complications.