Transradial percutaneous coronary interventions using sheathless guiding catheters: a multicenter registry

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Surgery

Background:

• Transradial approach (TRA) for percutaneous coronary interventions (PCIs) offers lower complication rates than transfemoral approach.
• A key limitation of TRA is the need for large guiding catheters, which can be challenging with small radial arteries.
• Sheathless guiding catheter systems, 1-2 French smaller than introducer sheaths, may overcome these limitations.

Purpose of the Study:

• To evaluate the feasibility and safety of a sheathless guiding catheter system in transradial percutaneous coronary interventions.
• To assess the utility of this system in patients with small radial artery caliber or undergoing complex bifurcation interventions.

Main Methods:

• A registry of 213 consecutive patients undergoing TRA-PCIs using a sheathless Eaucath guiding catheter system was conducted across 5 Italian hospitals (Jan 2010-Dec 2010).
• Patients were divided into two groups: Group 1 (n=79) with small radial artery caliber and Group 2 (n=134) undergoing bifurcation PCIs.
• A 6.5-Fr sheathless catheter was used in Group 1, and a 7.5-Fr in Group 2.

Main Results:

• A total of 270 vessels and 316 lesions were treated without requiring conversion to conventional systems.
• Group 1 had a higher proportion of female patients who were older, shorter, and thinner than Group 2.
• No major vascular complications were reported in either group; adjunctive devices like intravascular ultrasound and thrombectomy catheters were used.

Conclusions:

• The sheathless guiding catheter system is a feasible and safe option for TRA-PCIs.
• This system is particularly beneficial for patients with small radial artery caliber and for complex coronary bifurcation interventions.