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Updated: Jul 2, 2026

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation

Upper-extremity Approach for Secondary Access in Transfemoral Transcatheter Aortic Valve Implantation

Published on: August 8, 2025

Atraumatic complex transradial intervention using large bore sheathless guide catheter.

M A Mamas^1,2, F Fath-Ordoubadi¹, D G Fraser¹

¹Manchester Heart Centre, Manchester Royal Infirmary, Manchester M13 9WL, United Kingdom.

Catheterization and Cardiovascular Interventions : Official Journal of the Society for Cardiac Angiography & Interventions

|August 30, 2008

Summary

This summary is machine-generated.

The Asahi sheathless guide catheter system allows larger catheters during transradial percutaneous coronary intervention. This novel system overcomes radial artery size limitations for complex procedures.

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Area of Science:

Interventional Cardiology
Vascular Access Techniques

Background:

Transradial percutaneous coronary intervention (PCI) is preferred, but sheath size limits device options.
Conventional introducer sheaths are 1-2F larger than the catheter, restricting complex PCI in patients with small radial arteries.

Observation:

A novel sheathless guide catheter system with a central dilator was used.
This system eliminates the need for a traditional introducer sheath during transradial PCI.

Findings:

A 7.5F sheathless system was successfully used in 16 transradial cases.
Procedures included rotablation, crush stent bifurcation lesions, proximal protection, and thrombectomy, which are challenging with conventional sheaths.

Implications:

The sheathless system enables larger French-size devices via the radial artery.
It expands treatment possibilities for complex coronary interventions in patients with limited radial artery diameter.