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Comparison of novel 6.5 Fr sheathless guiding catheters versus 5 Fr guiding catheters for transradial coronary
Paul T L Chiam1, Bing Liu, Aaron S L Wong
1Department of Cardiology, National Heart Center Singapore, Singapore. paul.chiam.t.l@nhc.com.sg
Insights
The novel sheathless 6.5 Fr guiding catheter (GC) demonstrated comparable safety and efficacy to standard 5 Fr GCs in transradial coronary interventions (TRI), achieving high procedural success and low radial artery occlusion rates.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Access
Background:
- Transradial coronary interventions (TRI) are increasingly performed using standard 5 Fr guiding catheters (GCs).
- Evaluating novel sheathless (SH) 6.5 Fr GCs is crucial for optimizing TRI procedures.
Purpose of the Study:
- To compare the safety and efficacy of a new sheathless 6.5 Fr hydrophilic-coated GC versus standard 5 Fr GCs in TRI.
- To assess procedural success, radial artery occlusion (RAO) rates, and other adverse events.
Main Methods:
- A comparative study included 269 patients undergoing TRI with either 6.5 Fr SH GCs or 5 Fr GCs.
- Key endpoints included procedural success, RAO, access-site complications, procedure duration, and contrast load.
Main Results:
- Both GC types achieved a procedural success rate of 95.2% with similar low RAO rates (0.7% in each group).
- The 6.5 Fr SH GC group experienced longer procedure times and higher contrast loads.
- Fewer access-site complications were noted in the SH GC group.
Conclusions:
- The 6.5 Fr SH GC is a safe and effective alternative to 5 Fr GCs in TRI, offering comparable success and low RAO rates.
- The SH GC may overcome limitations of 5 Fr GCs and could become a preferred choice for TRI.
Aims:
To assess the safety and efficacy of a novel sheathless (SH) 6.5 Fr (French) hydrophilic-coated guiding catheter (GC) compared to the standard 5 Fr GCs in transradial coronary interventions (TRI).
Methods And Results:
Patients undergoing TRI with 6.5 Fr SH or 5 Fr GCs were included. Baseline characteristics and in-hospital outcomes were recorded. Primary endpoints were procedural success and presence of radial pulse at discharge. Secondary endpoints were successful GC support, in-hospital adverse events, access-site complications, procedural duration and contrast load. There were 269 patients with 146 procedures in each group. The SH GC group had more non-ST elevation MI, in-stent restenosis, high-risk and bifurcation lesions. Procedural success in both arms was 95.2%. One patient in each group (0.7%) experienced radial artery occlusion (RAO) after TRI, without clinical sequelae. One access-site haematoma and one minor stroke occurred in the 5 Fr group (none in the SH group, both p=ns). Mean procedure time (52±21 vs. 45±21 minutes, p=0.004) and contrast load (160±45 ml vs. 140±45 ml, p=0.003) were greater in the SH group.
Conclusions:
Both 6.5 Fr SH GCs and 5 Fr GCs achieved high procedural TRI success with low RAO rates. The SH GC eliminated the disadvantages of the 5 Fr GC whilst maintaining the advantage of low RAO rates, and may become the GC of choice in TRI.
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