Reducing needle-to-balloon time by using a single guiding catheter during transradial primary coronary intervention

It is unknown whether using a single guiding catheter for both nonculprit and culprit vessel angiography and intervention during transradial primary percutaneous coronary intervention (PCI) is feasible.

This single-center study enrolled 242 consecutive patients with ST segment elevation myocardial infarction (STEMI) who received primary PCI. Among them, 102 patients received primary PCI via transfemoral approach (TFI), 109 patients received primary PCI via transradial approach using conventional technique (Conventional TRI), and 31 underwent primary TRI using a single guiding catheter (Single Guiding TRI). The catheter used for this purpose was 6 Fr RM® 3.5 guiding catheter.

Using a single guiding catheter, both coronary artery angiograms and intervention were successful in 30 of 31 patients (96.7%). Needle-to-balloon time (from puncture to first balloon) and door-to-balloon (D2B) time were similar between TFI and Conventional TRI groups and significantly lower in the Single Guiding TRI group (13.8 [TFI] and 14.1 [Conventional TRI] vs. 7.6 minutes, P < 0.001; 89.5 [TFI] and 91.0 [Conventional TRI] vs. 68.5 minutes, P = 0.008, respectively), whereas proportion of patients achieving D2B time within 90 minutes increased significantly in the Single Guiding TRI group from 51.0% for TFI and 49.5% for Conventional TRI to 74.2% (P = 0.023).

Primary transradial PCI using a single guiding catheter is feasible and highly successful and might allow timely restoration of blood flow in infarct-related artery.