[Coronary transluminal angioplasty using 6-french diagnostic catheters. A preliminary study]

This preliminary study was undertaken to assess the potential indication and limitations of the use of 6 French guiding catheters for percutaneous transluminal coronary angioplasty (PTCA). Between September 1992 and October 1993, 100 consecutive patients with an average age of 64 +/- 11 years underwent 6 F angioplasty for: stable angina (38.7%), unstable angina (32.4%), non Q-wave or infarction recanalized by thrombolytic therapy (18%), and acute myocardial infarction (10.8%). Eighty per cent of the pTCAs were performed immediately after diagnostic coronary angiography. Single vessel disease accounted for 93.7% of cases. Of the 118 lesions treated, 46.6% were types A or B1, 44.9% were type B2 and 8.4% were type C. The success rate of 6 F PTCA was 96.4% using an average of 1.08 guides and 1.25 balloon catheters per patient. Stenosis decreased from 83 +/- 10% to 26 +/- 16%. There were 4 technical failures: in 1 case it was not possible to pass a chronic occlusion, in 1 case coronary dissection was complicated by infarction, and in 2 cases a 7 F guiding catheter was required for successful PTCA. No patients required emergency coronary bypass surgery and there were no fatalities during the procedure. Four patients required perfusing balloon catheters and 8 were stented with a Palmaz-Schatz endoprosthesis with the 6 F catheter. These results are comparable to those obtained with larger diameter guiding catheters. In view of the good coronary ostial tolerance, the lower rate of local complications at the site of arterial puncture and the possibility of earlier mobilisation of patients after the procedure, the indications for 6 F PTCA should increase.