• Jung-Hee Lee, Young Jin Youn, Ho Sung Jeon, Jun-Won Lee, Sung Gyun Ahn, Junghan Yoon, Hyeon-Cheol Gwon, Young Bin Song, Ki Hong Choi, Hyo-Soo Kim, Woo Jung Chun, Seung-Ho Hur, Chang-Wook Nam, Yun-Kyeong Cho, Seung Hwan Han, Seung-Woon Rha, In-Ho Chae, Jin-Ok Jeong, Jung Ho Heo, Do-Sun Lim, Jong-Seon Park, Myeong-Ki Hong, Joon-Hyung Doh, Kwang Soo Cha, Doo-Il Kim, Sang Yeub Lee, Kiyuk Chang, Byung-Hee Hwang, So-Yeon Choi, Myung Ho Jeong, and Hyun-Jong Lee.
• Division of Cardiology, Department of Internal Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea.
• J. Korean Med. Sci. 2024 Mar 18; 39 (10): e111e111.

BackgroundThe benefits of transradial access (TRA) over transfemoral access (TFA) for bifurcation percutaneous coronary intervention (PCI) are uncertain because of the limited availability of device selection. This study aimed to compare the procedural differences and the in-hospital and long-term outcomes of TRA and TFA for bifurcation PCI using second-generation drug-eluting stents (DESs).MethodsBased on data from the Coronary Bifurcation Stenting Registry III, a retrospective registry of 2,648 patients undergoing bifurcation PCI with second-generation DES from 21 centers in South Korea, patients were categorized into the TRA group (n = 1,507) or the TFA group (n = 1,141). After propensity score matching (PSM), procedural differences, in-hospital outcomes, and device-oriented composite outcomes (DOCOs; a composite of cardiac death, target vessel-related myocardial infarction, and target lesion revascularization) were compared between the two groups (772 matched patients each group).ResultsDespite well-balanced baseline clinical and lesion characteristics after PSM, the use of the two-stent strategy (14.2% vs. 23.7%, P = 0.001) and the incidence of in-hospital adverse outcomes, primarily driven by access site complications (2.2% vs. 4.4%, P = 0.015), were significantly lower in the TRA group than in the TFA group. At the 5-year follow-up, the incidence of DOCOs was similar between the groups (6.3% vs. 7.1%, P = 0.639).ConclusionThe findings suggested that TRA may be safer than TFA for bifurcation PCI using second-generation DESs. Despite differences in treatment strategy, TRA was associated with similar long-term clinical outcomes as those of TFA. Therefore, TRA might be the preferred access for bifurcation PCI using second-generation DES.Trial RegistrationClinicalTrials.gov Identifier: NCT03068494.© 2024 The Korean Academy of Medical Sciences.

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