Iliac and vascular intervention by radial: Italian registry

1. ITALIAN RADIAL FORCE
Feasibility of the radial approach for
iliac angioplasty
results from a multicenter study
Bernardo Cortese, MD, FESC
interventional cardiology, A.O. Fatebenefratelli Milano
bcortese@gmail.com
Cortese, Lorenzoni, Latib, Sbarzaglia, Pitì, Tommasino, Bovenzi, Burzotta,
Colombo, Tarantino, Cremonesi, Trani
Milano, Roma, Cotignola, Lucca, Bergamo

2. Disclosure Statement of Financial Interest
Within the past 12 months, I or my spouse have had a financial
interest/arrangement or affiliation with the organizations listed
below.
Affiliation/Financial Relationship Company
• Grant/Research Support
• Consulting
Fees/Honoraria
• Advisory board
• Movi, AB Medica
• Cardionovum, Abbott
Vascular, Hexacath,
Astra Zeneca, Terumo
• Medtronic/Invatec

3. TRI, a single center experience
iliac interventions, comparison of
consecutive pts (different operators)-
TF and TR accesses
PE: procedural success
SE: fluoroscopy time; procedural time
B. Cortese, LINC 2012; Cardiovascular Rev. Med 2012

4. TRI, a single center experience
B. Cortese, LINC 2012; Cardiovascular Rev. Med 2013

5. TRI, a single center experience
procedural success: 100%
p = NS p = NS
120
90
60
30
0
procedural time, min
radial femoral
radial
femoral
20
15
10
5
0
fluoroscopy time, min
radial femoral
radial
femoral
B. Cortese, LINC 2012; Cardiovascular Rev. Med 2013

6. study features
multicenter study coordinated by Italian
Radial Force
aims: feasibility and safety of iliac TRI
PE: procedural success;
1-mo. freedom from sympt./TVR/
complications

7. centers and enrollment
Milano (Cortese)
Roma-Gemelli (Trani )
Lucca-Campo di Marte (Lorenzoni)
Cotignola-GVM (Sbarzaglia)
Milano-San Raffaele (Latib )
149 consecutive pts with transradial iliac
interventions

8. clinical data of population

9. Rutherford classification
type 2
type 3
type 4
type 5
TASC lesion classification
type A
type B
type C
type D
clinical data of population
B. Cortese, Int J Cardiol ‘14

10. angio and technical data
B. Cortese, Int J Cardiol ‘14

11. technical data
approach
introducer
right
radial
left radial
Cook 90 cm
Optimed Epsylar 120 cm
Terumo Destination 90 cm
Asahi sheathless 100-120
cm
B. Cortese, Int J Cardiol ‘14

12. patients
final treatm. strategy
B. Cortese, Int J Cardiol ‘14

13. results-clinical endpoints
PE: 146/149 patients (98,0%)
0 20 40 60 80 100
in-hospital MACE
0 20 40 60 80 100
1-mo freedom from sympt. 97,3%
0 20 40 60 80 100
0 20 40 60 80 100
1-mo TVR
1-mo radial occlusion (3 centers)
0,7%
2,7%
B. Cortese, Int J Cardiol ‘14

14. technical data
40
30
20
10
0
fluoro time, min
N/A
center 1
center 2
center 3
center 4
center 5
average
femoral…
100
75
50
25
0
procedural time, min
N/A N/A
center 1
center 2
center 3
center 4
center 5
average
femoral…
B. Cortese, Int J Cardiol ‘14

15. TR iliac interventions
“closed” issues
descending aorta engagement
distance and backup support
safety
B. Cortese, Int J Cardiol ‘14

16. TR iliac interventions-open
issues
fate of radial artery with a big introducer
(45% of pt >6 Fr introducer)
different techniques – same results

17. conclusions
this study shows how a transradial
approach is feasible and safe for the
treatment of iliac disease and does not
increase procedural complication rates,
in experienced hands.

18. ITALIAN RADIAL FORCE
Feasibility of the radial approach for
iliac angioplasty
results from a multicenter study
Bernardo Cortese, MD, FESC
interventional cardiology, A.O. Fatebenefratelli Milano
bcortese@gmail.com
Cortese, Lorenzoni, Latib, Sbarzaglia, Pitì, Tommasino, Bovenzi, Burzotta,
Colombo, Tarantino, Cremonesi, Trani
Milano, Roma, Cotignola, Lucca, Bergamo