Outpatient coronary angiography using 7 French catheters in Singapore

Out-patient coronary angiogram (OCA) is commonly performed in many centres using 5 or 6 French (F) catheters. Though this small catheter may reduce bleeding complications, manipulatability and adequate vessel visualisation are problems which may increase procedure time. 7 or 8 F catheters have been used in Caucasians. We report our experience with OCA using 7 F catheters in an Asian centre.

Sixty-six patients with low procedural risk were consecutively recruited. They were pre-medicated with oral diazepam. Selective coronary angiogram (SCA) and left ventriculogram were performed via the femoral artery. Parenteral heparin was administered after the arterial puncture. After the procedure, haemostasis was secured by at least ten minutes of manual compression. The patients were immobilised for six hours and thereafter encouraged to walk for about an hour. The groin was inspected by a doctor before discharge and reviewed the following day.

The age ranged from 27 to 73 years with a mean of 52.6. There were 48 men and 18 women. Seventeen patients had previous SCA or angioplasty. There was no significant coronary artery disease (CAD) in 26 patients (39.4%). Thirteen patients (19.7%) had minor CAD, 20 (30.3%) had single or double vessel and 7 (10.6%) had triple vessel disease. The mean procedural time was 16.6 +/- 7.3 minutes, ranging from 7 to 54. Seven (10.6%) of the patients had a small haematoma prior to discharge. None of the haematoma deteriorated at review. We did not find sex, age, history of diabetes mellitus or hypertension, height, weight, body mass index, use of anti-platelet agents, systolic blood pressure at and after the procedure and coronary artery anatomy to be associated with an increased risk of haematoma. The estimated cost savings for a non-subsidized patient was S$285 and for a subsidized patient was S$66.

We conclude that OCA using 7 F catheters is a safe and efficacious procedure in our patients.