A new miniature catheter with side-holes for percutaneous transradial or transbrachial coronary angiography

Area of Science:

• Cardiovascular Medicine
• Medical Devices
• Interventional Cardiology

Background:

• Percutaneous arm approach (radial or brachial artery) for cardiac catheterization offers benefits like fewer access-site complications and reduced patient discomfort.
• High-flow contrast jets from end-hole catheters can cause vascular damage, including coronary dissection and myocardial blushing.
• Existing catheter designs pose risks during contrast injection in coronary angiography.

Purpose of the Study:

• To design and evaluate a novel miniature (4 French) catheter with side-holes for coronary angiography.
• To assess the impact of side-holes on jet pressure and vascular wall interaction compared to end-hole catheters.
• To determine the clinical feasibility and effectiveness of the new catheter in radial artery procedures.

Main Methods:

• Developed a new 4 French catheter with two side-holes for coronary angiography.
• Simulated clinical conditions to measure jet pressure and catheter-wall force relationships.
• Conducted a preliminary clinical study using the new side-hole catheters via the radial artery.

Main Results:

• Side-holes significantly reduced jet pressure compared to end-hole designs across various injection rates (2.0-3.5 ml/second) and applied forces (0-15 gf).
• Catheter location (side-hole position) did not influence the pressure reduction.
• Preliminary clinical use demonstrated feasibility and effectiveness, with reduced catheter dislodgement and improved visualization of coronary anatomy.

Conclusions:

• The new miniature side-hole catheter design effectively mitigates high-pressure jet complications during coronary angiography.
• This catheter is a safe and effective alternative for diagnostic cardiac catheterization via the radial artery.
• Improved contrast distribution enhances visualization and reduces procedural risks.