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Efficacy and safety of sheathless guiding catheter for distal radial approach
Takeshi Yamada1, Takuya Izumikawa2, Shiori Kawakami1
1Cardiovascular Department, Sakurakai Takahashi Hospital, Kobe, Hyogo, Japan.
Insights
This study shows that a 6-French sheathless guiding system is effective for percutaneous coronary intervention (PCI) using distal radial access (DRA). The system demonstrated a high success rate with minimal access site complications, including low rates of radial artery occlusion.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Medical Devices
Background:
- Transradial percutaneous coronary intervention (PCI) is a common procedure.
- Distal radial access (DRA) offers potential advantages over traditional radial access.
- Novel guiding systems aim to improve procedural efficiency and reduce complications.
Purpose of the Study:
- To evaluate the efficacy and safety of a sheathless guiding system for PCI via DRA.
- To assess procedural success rates and access site complications associated with the sheathless system.
Main Methods:
- A prospective study involving 286 patients undergoing PCI with a 6-Fr sheathless guiding catheter (Hyperion™ Sheathless®) via DRA.
- Data collected on procedural success, bleeding events, and radial artery occlusion (RAO) at 30-day follow-up.
Main Results:
- High procedural success rate of 99.7% with no conversions to conventional radial access.
- Low incidence of access site complications: 2 Grade II and 23 Grade I hematomas, no major bleeding.
- Radial artery occlusion (RAO) rate was 2.2% (6/277 patients) at 30 days.
Conclusions:
- The 6-French sheathless guiding system is a feasible and safe option for PCI utilizing distal radial access.
- This approach is associated with a low occurrence of access site complications, including bleeding and RAO.
Objectives:
This study aimed to assess the efficacy and safety of a sheathless guiding system in patients who underwent percutaneous coronary intervention (PCI) with distal radial access (DRA).
Background:
Hyperion™ Sheathless® guiding catheter (Asahi Intecc, Japan), one of the latest 6-Fr guiding systems for transradial PCI characterized by novel outer dilator, is considered to facilitate smooth insertion of the catheter to the artery and may contribute to further reduction of access site complications in DRA.
Methods:
Between October 2018 and January 2023, 286 patients underwent PCI with a Hyperion™ Sheathless® guiding catheter with DRA at two Japanese hospitals. Procedural success, bleeding complications, and radial artery occlusion (RAO) detected by Doppler ultrasonography were assessed.
Results:
Mean age of the patients was 72.7 years, and 236 patients (82.5 %) were male. The target lesions were located in the right coronary artery, left anterior descending artery, left circumflex artery, and left main trunk in 81, 44, 50 patients, and 18 patients respectively. Procedural success rate was 99.7 % with no patients requiring conversion to conventional radial access. Two patients presented with a forearm hematoma equivalent to an Early Discharge After Transradial Stenting of Coronary Arteries Study hematoma classification Grade II and 23 with Grade I. No patient presented minor or major bleeding according to the Thrombolysis in Myocardial Infarction bleeding classification. RAO at 30-day follow-up was observed in 6 out of 277 patients (2.2 %).
Conclusions:
6-Fr sheathless guiding system for PCI via DRA is feasible and associated with a low incidence of access site complications.
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