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
ARTICLE HIGHLIGHTS
Research background

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.

Research motivation

Methods to provide extra back-up support may improve procedural success with reduced complications. A rapid exchange guide extension catheter can provide the convenient and efficient back-up support in the TRI procedures.

Research objectives

The purpose of our study was to evaluate the efficacy and safety of rapid exchange extension catheter in the treatment of complex coronary lesions via the radial access.

Research methods

A total of 135 patients with type B2/C nonocclusive lesions underwent transradial coronary interventions in the study. The clinical characteristics, indications for use of the rapid exchange extension catheter, procedural details, procedure-related complications, and major adverse cardiovascular events were recorded and analyzed.

Research results

Technique success (successful crossing of the target lesion with this technique) rate was up to 94.8%. The most common indication for the use of a rapid exchange extension catheter was vascular tortuosity, followed by heavy calcification, long lesions, proximal stent, in-stent restenosis, and coronary origin anomalies. The following technologies failed in passing targeted lesions before delivering the rapid exchange catheter: Multiple predilatation technique, buddy wire technique, balloon anchoring technique, and cutting balloon modification. The rapid exchange extension catheter technique showed effectiveness for the balloon and stent deliver in the transradial coronary interventions of type B2/C nonocclusive coronary lesions.

Research conclusions

The findings of our study revealed the efficacy and safety of a rapid exchange extension catheter 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.

Research perspectives

Our study was designed as a retrospective study and was performed at a single study center. Potential patient selection bias and influence by operator experience might have affected the accuracy and efficacy. Larger, multicenter, randomized controlled studies are warranted.