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Feasibility and safety of 7F sheathless guiding catheter during transradial coronary intervention
Tak W Kwan1, Sanjay Cherukuri, Yili Huang
1Division of Cardiology, Beth Israel Medical Center, New York, New York 10013, USA. Kwancardio@aol.com
Insights
The 7F sheathless guiding catheter shows high success in transradial interventions. This method has a low rate of radial artery occlusion (RAO) at 30 days, making it a safe option.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Access
Background:
- Complex coronary interventions often require large bore guiding catheters.
- Sheathless guiding catheters are not widely available in the US.
- A modified sheathless technique using available catheters was employed.
Purpose of the Study:
- To evaluate the feasibility and safety of using a 7F sheathless guiding catheter in transradial intervention (TRI).
- To determine the rate of radial artery occlusion (RAO) following TRI with this technique.
Main Methods:
- A multicenter study included 116 consecutive patients undergoing TRI.
- The procedure utilized a 7F sheathless guiding catheter.
- Data on procedural success and RAO at 7 and 30 days were collected.
Main Results:
- The study involved 116 patients and 123 coronary lesions, with 49% being complex interventions.
- Overall procedural success rate was 95%.
- At 30 days, the persistent radial artery occlusion rate was 2.5%.
Conclusions:
- The 7F sheathless guiding catheter technique for TRI is feasible and safe.
- This approach is associated with a high procedural success rate (95%) and a low 30-day RAO rate (2.5%).
Objective:
The aim of our study is to assess the feasibility, safety, and rate of radial artery occlusion (RAO) using 7F sheathless guiding catheter in a large population undergoing transradial intervention (TRI).
Background:
There is a frequent need for large bore guiding catheter to perform complex coronary interventions. Hydrophilic sheathless guiding catheters are not available in the US, therefore, we present the results of a multicenter study using the modified sheathless technique and readily available catheters.
Methods:
Between December 2010 and February 2011, 116 consecutive patients from four tertiary US centers who underwent TRI using 7F sheathless guiding catheter were included in this study.
Results:
In our study of 116 patients with 123 coronary lesions, 57 stenoses (49%) were complex interventions, which included patients with acute coronary syndromes, chronic total occlusion (CTO), bifurcation stenting, calcified lesions, left main artery, and saphenous venous graft interventions. Overall procedural success rate was 95%. At 7-day, there were six patients (5%) with RAO, of which two of the six had severe radial artery spasm during the procedure. At 30-day, the overall persistent RAO was only detected in three patients (2.5%), as three patients had return of antegrade radial artery flow.
Conclusions:
In our multicenter study of 116 consecutive patients, using 7F sheathless guiding catheter to perform TRI is associated with a high procedural success (95%) and a low 30-day RAO rate (2.5%).
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