A Randomized Study of SheathLess vs Standard Guiding Catheters for Transradial Percutaneous Coronary Interventions

Area of Science:

• Cardiology
• Interventional Cardiology
• Vascular Access

Background:

• Small radial artery diameter limits transradial percutaneous coronary intervention (PCI).
• Sheathless guiding catheters (GCs) present a potential solution to overcome this limitation.

Purpose of the Study:

• To compare the efficacy and safety of sheathless GCs versus standard GCs in transradial PCI.
• To evaluate patient comfort and operator ease of use with sheathless GCs.

Main Methods:

• A randomized trial involving 233 transradial PCIs between 2011 and 2013.
• Comparison of standard GC (Medtronic Launcher) and SheathLess Eaucath GC (Asahi Intecc).
• Inclusion criteria: men with ostial/bifurcation lesions, and all women.

Main Results:

• Successful transradial PCI with the designated GC was superior with SheathLess GC (96.5%) vs. standard GC (89.9%; P=0.047).
• No significant differences in overall PCI success, safety endpoints, procedure duration, or contrast volume.
• SheathLess GC significantly reduced patient arm pain (P < 0.001) and improved operator-assessed arm crossability (P < 0.001).

Conclusions:

• Sheathless GCs are superior to standard GCs for successful transradial PCI in selected lesions (large-bore catheters in men) and all lesions in women.
• Sheathless GCs enhance patient comfort and procedural ease during transradial PCI.