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Use of the sheathless guide catheter during routine transradial percutaneous coronary intervention: a feasibility
Mamas Mamas1, Savio D'Souza, Cara Hendry
1Manchester Heart Centre, Manchester Royal Infirmary, Biomedical Research Centre, Manchester, United Kingdom.
Insights
This study demonstrates the feasibility of using a 6.5 Fr sheathless guide catheter system for transradial percutaneous coronary intervention (PCI). This approach achieved 100% procedural success with low rates of radial spasm and occlusion.
Area of Science:
- Interventional Cardiology
- Vascular Access Techniques
- Medical Device Innovation
Background:
- Transradial percutaneous coronary intervention (PCI) reduces mortality and bleeding complications compared to femoral access.
- Larger sheath sizes in transradial PCI are associated with increased complication rates.
- Sheathless guide catheter systems offer a smaller profile, potentially mitigating access site issues.
Purpose of the Study:
- To evaluate the feasibility of using a 6.5 Fr sheathless guide catheter as a default system for transradial PCI.
- To assess procedural success rates and complication profiles associated with this novel system.
Main Methods:
- A prospective study involving 100 consecutive transradial PCI cases.
- Utilized a 6.5 Fr sheathless guide catheter system as the primary approach.
- Monitored procedural success, symptomatic radial artery spasm, and radial artery occlusion at two months.
Main Results:
- Achieved 100% procedural success without the need for conversion to conventional systems.
- No procedural complications were directly attributed to the sheathless catheter system.
- Reported a 5% rate of symptomatic radial artery spasm and a 2% rate of radial artery occlusion at two months.
Conclusions:
- The 6.5 Fr sheathless guide catheter system is a feasible default option for routine transradial PCI.
- This system demonstrates high procedural success and a favorable safety profile via the radial artery.
- The sheathless design, with an outer diameter comparable to a <5 Fr sheath, contributes to its efficacy.
Objective:
The aim of this study is to investigate the feasibility of using a 6.5 Fr sheathless guide catheter as a default system in transradial (TRA) percutaneous coronary intervention (PCI).
Background:
TRA PCI has been shown to reduce mortality rates through a reduction in access site related bleeding complications compared with procedures performed though a femoral approach. Complications associated with the TRA route increase with the size of sheath used. These complications may be reduced by the use of a sheathless guide catheter system (Asahi Intecc, Japan) that is 1-2 Fr sizes smaller in diameter than the corresponding introducer sheath.
Methods:
We performed PCI in 100 consecutive cases using 6.5 Fr sheathless guides to determine the procedural success, rates of symptomatic radial spasm and radial occlusion.
Results:
Procedural success using the 6.5 Fr sheathless guide catheter system was 100% with no cases requiring conversion to a conventional guide and catheter system. There were no procedural complications recorded associated with the use of the catheter. Adjunctive devices used in this cohort included IVUS, stent delivery catheters, distal protection devices, and simple thrombectomy catheters. The rate of radial spasm was 5% and the rate of radial occlusion at 2 months was 2%.
Conclusion:
Use of the 6.5 Fr sheathless guide catheter system, which has an outer diameter <5 Fr sheath, as the default system in routine PCI is feasible with a high rate of procedural success via the radial artery.
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