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Published on: February 18, 2020
A Single Transradial Guiding Catheter in Patients With ST-Segment Elevation Myocardial Infarction Undergoing
Jorge Antonio Cervantes-Nieto1, Juan Andres Pimentel-Esparza2, Omar Gomez-Monterrosas3
1Cardiology, National Institute of Cardiology Ignacio Chávez, Mexico City, MEX.
Insights
The 6-French Ikari Left guide catheter offers a single-catheter approach for ST-elevation myocardial infarction (STEMI) patients, reducing procedure times and complications. This method shows comparable success rates to traditional techniques with improved efficiency.
Area of Science:
- Cardiology
- Interventional Cardiology
- Medical Devices
Background:
- Acute coronary syndrome (ACS) remains a leading global cause of death.
- Percutaneous coronary intervention (PCI) has improved outcomes but faces challenges, including procedure time.
- Reducing patient care time from diagnosis to reperfusion is critical for STEMI management.
Purpose of the Study:
- To evaluate the 6-French Ikari Left guide catheter for radial angiography-angioplasty in ST-elevation myocardial infarction (STEMI) patients.
- To assess the feasibility of a single-catheter strategy to reduce patient care times.
- To compare outcomes with the traditional Judkins catheter approach.
Main Methods:
- Retrospective analysis of STEMI patients undergoing radial angiography-angioplasty.
- Utilized the 6-French Ikari Left guide catheter for both diagnostic and interventional procedures.
- Compared procedural times, success rates, and complication rates with historical data and international series.
Main Results:
- The 6-French Ikari Left catheter achieved diagnostic angiography and PCI success rates comparable to other centers.
- This approach demonstrated lower complication rates than the standard Judkins catheter method.
- Shorter needle-device time and fluoroscopy time were observed.
Conclusions:
- The 6-French Ikari Left guide catheter is an effective alternative for STEMI treatment, potentially reducing procedural times.
- This single-catheter strategy shows promise for improving efficiency and patient outcomes in interventional cardiology.
- Limitations include a small sample size and a highly selected patient population.
Abstract:
Background Acute coronary syndrome (ACS) is the leading cause of morbidity and mortality worldwide. The different reperfusion strategies have evolved over the years, and efforts have been directed to reduce its complications. Among these strategies, the one that has shown the best results is percutaneous coronary intervention, which has significantly improved the survival and prognosis of these patients; however, this procedure is not free of complications since multiple factors are involved. Among them is the time of patient care from the time of diagnosis until the coronary reperfusion therapy is performed. Methodology In this study, we describe the experience in our center with the 6-French Ikari Left guide catheter as a strategy of radial angiography-angioplasty with a single catheter to reduce the care times of patients with acute ST-elevation myocardial infarction (STEMI) in our center and compare it with the series reported by other international centers since. To establish an alternative to the usual approach that consists of the use of Judkins catheters, diagnosis, and guiding. Results Our study showed a success rate for diagnostic angiography and percutaneous coronary intervention (PCI) with the 6- French Ikari Left catheter comparable to those obtained in other centers, even with lower complication rates than the usual approach with Judkins' Catheters. Conclusions The use of the 6-French Ikari Left catheter demonstrated shorter needle-device time and compared to other international series, it was shown to be shorter and related to shorter fluoroscopy time. Our study has a small sample and only included a highly selected population, which represents a limitation. This study is vulnerable to the different practices of the operators, with involvement in procedure time and use of contrast volume.
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