clinical NEWS

May 17, 2O22

CTO PCI Outcomes Similar with Radial or Femoral Access

A new study showed that transradial access (TRA) is as effective as transfemoral access (TFA) in percutaneous coronary intervention (PCI) for chronic total occlusion (CTO). (1)

CTO is a complete or nearly complete obstruction of a coronary artery, making it the most severe form of coronary artery disease (CAD). Because of its complexity, open-heart surgery was historically preferred for treating CTO but PCI has been gaining ground in recent years. While TRA has known benefits especially in reducing access site bleeding, CTO PCI has been usually performed via TFA as it allows the use of larger guiding catheters to provide better equipment support.  

The Femoral or Radial Approach in the Treatment of Coronary Chronic Total Occlusion (FORT CTO) study included 610 patients who were referred for CTO PCI from August 2017 to July 2021 at four hospitals in Turkey. The study looked at procedural difficulties and outcomes between using radial or femoral access in performing CTO PCI.

The results showed no differences in duration, contrast and radiation use, and crossover rate between the two groups. TRA showed non-inferiority to TFA in terms of procedural success (84% vs 86%). TRA also showed fewer access site complications (2.0% vs 5.6%) than TFA.

The results of the study might not be applicable in all facilities as the clinical operators in the study were highly experienced in both TRA and CTO PCI and the cases were not as highly complex as other contemporary studies but the FORT CTO study provided more evidence in support of the use of TRA in complex procedures.  

Adequate support is an important factor in complex PCI, which is why TFA is preferred in these types of cases. But given the results of the FORT CTO study, adequate support can also be achieved in TRA. Incidentally, the main sheath and guide catheter size used in either TFA or TRA groups in the study was 7Fr with only 24% of the TRA cases using 6Fr. This suggests that operator technique is more crucial for procedural success than the choice of arterial access.


1.    Gorgulu S, Kalay N, Norgaz T, et al. Femoral or Radial Approach in Treatment of Coronary Chronic Total Occlusion. J Am Coll Cardiol Intv. 2022 Apr, 15 (8) 823–830.

テクノウッド SoftNAVカテーテル

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Technowood SoftNAV Catheter

Technowood’s SoftNAV catheters were designed to address various clinical needs in the cath lab. With its larger lumen size, hydrophilic coating and unique tip shapes, SoftNAV catheters were optimized for use via transradial approach.


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