Kim Kyunyeon, Jung Jin, Her Sung-Ho, Lee Kyusup, Jung Ji-Hoon, Yoo Ki-Dong, Moon Keon-Woong, Moon Donggyu, Lee Su-Nam, Jang Won-Young, Choi Ik-Jun, Lee Jae-Hwan, Lee Jang-Hoon, Lee Sang-Rok, Lee Seung-Whan, Yun Kyeong-Ho, Lee Hyun-Jong
Department of Cardiology, St. Vincent's Hospital, The Catholic University of Korea, Seoul 16247, Republic of Korea.
Department of Cardiology, Daejeon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul 34943, Republic of Korea.
J Clin Med. 2025 Apr 29;14(9):3066. doi: 10.3390/jcm14093066.
Rotational atherectomy (RA) is a crucial method for percutaneous coronary intervention (PCI) of heavily calcified coronary lesions. The aim of this study was to compare the clinical outcomes in patients undergoing RA via the radial versus femoral approach. The Rotational Atherectomy in Calcified Lesions in Korea (ROCK) registry included consecutive patients with severely calcified coronary artery disease who received RA during PCI at nine tertiary centers in Korea. A total of 540 patients who underwent PCI with RA were enrolled between October 2019 and January 2010. We retrospectively investigated the clinical outcomes between the transradial and transfemoral approaches. The primary endpoint was major adverse cardiac and cerebrovascular events (MACCE) within 36 months of follow-up. Of the 540 patients, 248 patients (45.9%) were in the transradial group, and 292 patients (54.1%) were in the transfemoral group. There were no significant differences in MACCE (11.3% vs. 17.8%, adjusted hazard ratio [HR]: 1.520; 95% confidence interval: 0.889-2.600; = 0.126) and procedural success (97.6% vs. 95.2%, = 0.145). The occurrence of in-hospital bleeding was numerically higher in the transfemoral group, but the difference was not statistically significant (8 [3.2%] vs. 19 [6.5%], = 0.081) In this study, the transradial approach did not show a significant difference in clinical outcomes but tended to have lower bleeding events compared to the transfemoral approach. RA via the transradial approach can be a useful vascular access option compared to the transfemoral approach.
旋磨术（RA）是重度钙化冠状动脉病变经皮冠状动脉介入治疗（PCI）的关键方法。本研究旨在比较经桡动脉与股动脉途径行RA患者的临床结局。韩国钙化病变旋磨术（ROCK）注册研究纳入了在韩国9家三级中心接受PCI期间行RA的连续性重度冠状动脉疾病患者。2019年10月至2010年1月期间，共有540例行RA的PCI患者入组。我们回顾性研究了经桡动脉与股动脉途径的临床结局。主要终点为随访36个月内的主要不良心脑血管事件（MACCE）。540例患者中，248例（45.9%）为经桡动脉组，292例（54.1%）为经股动脉组。MACCE（11.3%对17.8%，调整后风险比[HR]：1.520；95%置信区间：0.889 - 2.600；P = 0.126）和手术成功率（97.6%对95.2%，P = 0.145）无显著差异。经股动脉组院内出血发生率在数值上更高，但差异无统计学意义（8例[3.2%]对19例[6.5%]，P = 0.081）。在本研究中，经桡动脉途径在临床结局方面未显示出显著差异，但与经股动脉途径相比，出血事件有减少趋势。与经股动脉途径相比，经桡动脉途径行RA可能是一种有用的血管入路选择。
