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Sheathless guide catheter in transradial percutaneous coronary intervention for ST-segment elevation myocardial
Masaki Miyasaka1, Norio Tada1, Shigeaki Kato1
1Department of Cardiology, Sendai Kousei Hospital, Sendai, Miyagi, Japan.
Insights
Sheathless guide catheters are safe and effective for transradial percutaneous coronary intervention (PCI) in ST-segment elevation myocardial infarction (STEMI) patients. This approach reduces vascular complications, offering a viable alternative for emergent cardiac procedures.
Area of Science:
- Cardiology
- Interventional Cardiology
- Vascular Access
Background:
- Transradial percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI) reduces vascular complications.
- Large-bore catheters can damage small radial arteries during transradial PCI.
- Sheathless guide catheters eliminate the need for an introducer sheath, potentially mitigating radial artery damage.
Purpose of the Study:
- To evaluate the safety and efficacy of sheathless guide catheters in transradial PCI for STEMI.
- To determine if this technique is suitable for emergent cardiac interventions.
Main Methods:
- Retrospective analysis of consecutive STEMI patients undergoing primary PCI.
- Study conducted at Sendai Kousei Hospital from September 2010 to May 2013.
- Primary endpoint: acute procedural success without access site crossover. Secondary endpoints: door-to-balloon time, fluoroscopy time, contrast volume, and radial artery stenosis/occlusion.
Main Results:
- Acute procedural success was achieved in 97.5% of 478 STEMI patients (466/478).
- Median door-to-balloon time was 45 minutes.
- Radial artery stenosis or occlusion occurred in 3.8% of evaluable patients (14/370).
Conclusions:
- Sheathless guide catheters are effective and safe for transradial primary PCI in STEMI.
- This technique offers a promising approach for emergent cardiac interventions.
- Further research may confirm long-term benefits and safety profiles.
Objectives:
The aim of this study was to assess the safety and efficacy of sheathless guide catheters in transradial percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI).
Background:
Transradial PCI for STEMI offers significant clinical benefits, including a reduced incidence of vascular complications. As the size of the radial artery is small, the radial artery is frequently damaged in this procedure using large-bore catheters. A sheathless guide catheter offers a solution to this problem as it does not require an introducer sheath. However, the efficacy and safety of sheathless guide catheters remain to be fully determined in emergent transradial PCI for STEMI.
Methods:
Data on consecutive STEMI patients undergoing primary PCI at the Sendai Kousei Hospital between September 2010 and May 2013 were analyzed. The primary endpoint was the rate of acute procedural success without access site crossover. Secondary endpoints included door-to-balloon time, fluoroscopy time, volume of contrast, and radial artery stenosis or occlusion rate.
Results:
We conducted transradial PCI for 478 patients with STEMI using a sheathless guide catheter. Acute procedural success was achieved in 466 patients (97.5%). The median door-to-balloon time was 45 min (range, 15-317 min). The median fluoroscopy time was 16.4 min (range, 10-90 min). The median volume of contrast was 134 mL (range, 31-431 mL). Radial stenosis or occlusion developed in 14 (3.8%) of the 370 evaluable patients.
Conclusions:
This study showed that use of a sheathless guide catheter taking a transradial approach was effective and safe in primary PCI for STEMI. © 2015 Wiley Periodicals, Inc.
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