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Clinical Usefulness of 8-F Sheathless Guiding Catheter for Transradial Approach in Complex Percutaneous Coronary

Hiroaki Matsuda1, Satoru Tohara2, Takeshi Niizeki3

  • 1Department of Cardiology, Chuno Kosei Hospital, Gifu, Japan.

JACC. Asia
|July 7, 2026
PubMed

Insights

This study shows that using an 8-F sheathless guiding catheter for complex transradial coronary intervention (TRI) is safe and effective. It resulted in a low incidence of radial artery occlusion (RAO) in patients undergoing complex percutaneous coronary intervention.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Vascular Access

Background:

  • Transradial coronary intervention (TRI) is a preferred approach for percutaneous coronary intervention.
  • Optimizing radial artery access and minimizing complications like radial artery occlusion (RAO) are crucial for successful TRI.
  • The use of larger sheaths or guiding catheters in complex TRI can increase the risk of vascular complications.

Purpose of the Study:

  • To evaluate the safety and efficacy of complex transradial coronary intervention (TRI) utilizing an 8-F sheathless guiding catheter (GC).
  • To assess the incidence of early radial artery occlusion (RAO) following complex TRI with an 8-F sheathless GC.
  • To determine the impact of nicorandil administration on radial artery diameter in patients undergoing TRI.

Main Methods:

  • A prospective study involving 106 consecutive patients undergoing complex TRI with an 8-F sheathless GC.
  • Ultrasound assessment of radial artery diameter before and after the procedure, following nicorandil administration.
  • Monitoring for clinical outcomes and incidence of radial artery occlusion (RAO) at early and 3-month follow-up.

Main Results:

  • All 106 patients successfully completed the complex TRI procedure using the 8-F sheathless GC.
  • Early RAO (within 24 hours) occurred in 3.1% of patients, and RAO within 3 months occurred in 6.6%.
  • Nicorandil administration significantly increased the mean radial artery inner diameter (from 2.80 ± 0.49 mm to 3.00 ± 0.56 mm).

Conclusions:

  • Complex TRI with an 8-F sheathless GC demonstrates favorable safety and efficacy.
  • The low incidence of RAO suggests this technique is well-tolerated and suitable for complex PCI.
  • This approach may be particularly beneficial for high-risk bleeding patients requiring complex percutaneous coronary intervention.

Keywords:
complex percutaneous coronary interventionnicorandilradial artery occlusionsheathless guiding catheterstransradial coronary intervention

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