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Background Compared with conventional bifemoral (BF) approach, radial plus ipsilateral femoral (RF) approach may be feasible in the percutaneous intervention for iliac artery chronic total occlusion (CTO). Materials/Methods We included patients underwent iliac CTO intervention between August 2009 to July 2018 in a tertiary referral center in Korea. Results A total of 83 patients were enrolled in this study. Of them, 51 and 32 patients were categorized into RF and BF initial access groups, respectively. The overall success rates were 98.0% and 96.7% in RF and BF group, and techniques were also similar including use of bilateral wiring, stent type and profile, and post balloon but longer procedure time in BF group. Additional contralateral femoral access was needed in 6 patients for the treatment of contralateral lesions, distal embolization, and due to tortuous right subclavian artery. Periprocedural complications including vascular injury, iliac perforation, distal embolization occurred similarly in both groups with numerically lower rate of periprocedural bleeding in the RF group (9.8%) compared to BF group (21.9%). Clinical follow-up at 6 months showed there were no difference in the rates of death, cardiovascular death, target-limb reintervention, and unplanned target limb amputation in both groups Conclusions RF approach for iliac CTO intervention was related to similar technical success rate with acceptable periprocedural safety outcomes compared to conventional BF approach.

BACKGROUND Aortic aneurysm (AA) is an enlargement of the aorta to greater than 1.5 times normal size. Although the US guideline recommends ultrasound screening for abdominal AA (AAA) in men older than 65 years regardless of symptoms, limited data describe the prevalence of AAA in Korea. In this study, we screened patients for AAA during transthoracic echocardiographic examination (TTE). METHODS We screened for AAA in all consecutive subjects older than 60 years who underwent TTE. We defined AAA as an abdominal aorta with the diameter greater than 30 mm. RESULTS We analyzed 5,679 persons (2,272 females, 74 ± 8 years old). The mean size of the abdominal aorta was 19.0 ± 6.1 mm. The prevalence of AAA was 2.9% (165/5,679) and was significantly higher in males (4.7% vs. 1.1%, p < 0.001). AAA was significantly associated with male sex (odds ratio [OR] = 3.098, 95% confidence interval [CI] = 1.971-4.870, p < 0.001), older age (OR = 1.074, 95% CI = 1.050-1.097, p < 0.001), non-diabetes (OR = 1.886, 95% CI = 1.264-2.813, p < 0.001), dyslipidemia (OR = 1.475, 95% CI = 1.019-2.135, p = 0.040), ever-smoker (OR = 2.090, 95% CI = 1.448-3.015, p < 0.001), chronic kidney disease (CKD, OR = 1.757, 95% CI = 1.182-2.612, p = 0.005), and coronary artery disease (CAD, OR = 2.452, 95% CI = 1.742-3.451, p < 0.001). A prediction score with a multivariate model (range: 3.34-10.51) detected AAA with a sensitivity of 79.4% and a specificity of 66.8% with a reference value > 6.8 (area under the curve = 0.799). CONCLUSIONS In Korea, the prevalence of AAA was 2.9% in subjects older than 60 years during TTE, and AAA was significantly associated with older age, male sex, non-diabetes, dyslipidemia, ever-smoker, CKD, and CAD. Prediction score (> 6.8%) detected AAA with a sensitivity of 79.4% and a specificity of 66.8%.