Retrospective Study
Copyright ©The Author(s) 2021. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Apr 26, 2021; 9(12): 2751-2762
Published online Apr 26, 2021. doi: 10.12998/wjcc.v9.i12.2751
Application of a rapid exchange extension catheter technique in type B2/C nonocclusive coronary intervention via a transradial approach
Hong-Chao Wang, Wei Lu, Zi-Han Gao, Ya-Nan Xie, Jie Hao, Jin-Ming Liu
Hong-Chao Wang, Zi-Han Gao, Ya-Nan Xie, Jie Hao, Jin-Ming Liu, Department of Cardiology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China
Wei Lu, Department of Cardiology, The Third Hospital of Shijiazhuang City, Shijiazhuang 050000, Hebei Province, China
Author contributions: Wang HC designed and performed the research and wrote the paper; Lu W, Gao ZH, and Xie YN provided clinical advice and performed the research; Hao J supervised the report and contributed to the analysis; Liu JM designed the research and supervised the report.
Institutional review board statement: The study was reviewed and approved by the Research Ethics Committee of The Second Hospital of Hebei Medical University (Approval No. 2020-P033).
Informed consent statement: All study participants, or their legal guardian, provided informed written consent prior to study enrollment.
Conflict-of-interest statement: There is no relevant conflict of interest.
Data sharing statement: Technical appendix, statistical code, and dataset available from the corresponding author at [liujinming74@163.com]. Participants gave informed consent for data sharing.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Jin-Ming Liu, MD, Associate Professor, Department of Cardiology, The Second Hospital of Hebei Medical University, No. 215 Heping West Road, Shijiazhuang 050000, Hebei Province, China. liujinming74@163.com
Received: December 24, 2020
Peer-review started: December 24, 2020
First decision: January 17, 2021
Revised: January 29, 2021
Accepted: February 24, 2021
Article in press: February 24, 2021
Published online: April 26, 2021
Processing time: 111 Days and 18.8 Hours
Abstract
BACKGROUND

In transradial intervention procedures, poor back-up support and noncoaxial alignment of the guide catheter (GC) may result in failure of the balloon or stent to reach the targeted lesion. Methods to provide extra back-up support using the original GC and wire can improve procedural success with reduced complications. A rapid exchange guide extension catheter provides convenient and efficient back-up support while preserving the initial GC and inserted wire.

AIM

To evaluate the efficacy and safety of rapid exchange extension catheter in the treatment of type B2/C nonocclusive coronary lesions via the radial access.

METHODS

A total of 135 patients with type B2/C nonocclusive lesions who were treated via the transradial approach were enrolled in the study. The clinical characteristics, indications for use of the rapid exchange extension catheter, and procedural details and results were reviewed and analyzed. All procedure-related complications and major adverse cardiovascular events were recorded during the in-hospital stay and follow-up period.

RESULTS

The most common indication for the use of a rapid exchange extension catheter was vascular tortuosity (37.8%), followed by heavy calcification (28.9%), long lesions (20.0%), proximal stent (6.7%), in-stent restenosis (5.2%), and coronary origin anomalies (1.5%). The following technologies failed in passing targeted lesions before delivering the rapid exchange catheter: Multiple predilatation technique (57%), buddy wire technique (33.4%), balloon anchoring technique (5.9%), and cutting balloon modification (3.7%). The mean depth of the extension catheter intubation was 20.56 ± 13.05 mm, and the mean rapid exchange catheter service time was 18.9 ± 9.7 min. The mean length and diameter of stents were 33.5 ± 14.4 mm and 2.75 ± 0.45 mm, respectively. The total rate of technique success (balloon or stent successful crossing of the target lesion with this technique) was 94.8%.

CONCLUSION

The rapid exchange extension catheter technique showed acceptable safety and efficacy in the transradial coronary interventions of type B2/C nonocclusive coronary lesions. We recommend this technique to assist in complex lesion intervention via radial access.

Keywords: Transradial intervention; Mother-child extension catheter; Percutaneous coronary intervention; Exchange extension catheter; Backup support; Type B2/C nonocclusive coronary lesions

Core Tip: Transradial intervention (TRI) has been widely used due to its advantages compared with the transfemoral approach. In TRI, poor back-up support may result in failure of the balloon or stent to reach the targeted lesion. A rapid exchange guide extension catheter provides convenient and efficient back-up support in the TRI procedures. The findings of our study revealed the efficacy and safety of the rapid exchange extension catheter for the balloon and stent delivery in the treatment of type B2/C nonocclusive coronary lesions. The rapid exchange extension catheter technique is a useful approach for complex coronary lesions via the radial access.