Poster abstract

Angina treatment

AS-155 Useful of the Sheathless Guide Catheter during Routine Transradial Percutaneous Coronary Intervention

Background

Transradial (TRA) percutaneous coronary intervention (PCI) has been shown to be safer than the femoral route in preventing access site bleeding complications and facilitates early ambulation. However, radial artery size is a frequent limitation to guide catheter selection. These complications may be reduced by the use of a sheathless guide catheter system(SGC) (Asahi Intec, Japan) that is 1.5 Fr sizes smaller in diameter than the corresponding introducer sheath.

We report the procedural success,

Methods

The procedural success of consecutive PCIs performed was assessed using 6.5F Asahi's SGCs with internal diameters equivalent to current 6F guides. We performed PCI in 344 consecutive cases (from Aug. 2009 to Aug. 2010) using 6.5 Fr sheathless guides(211 cases) and 6F guides(122 cases) to determine the procedural success, rates of symptomatic radial spasm and radial occlusion. Radial artery patency was assessed at 3 month in the palpate.

Results

Reasons for brakial or femoral access included prior CABG (0), cardiogenic shock (0), patient request (0), absent radial pulse (1) and radial artery spasm (2). Procedural success was 100% (0 crossover to a sheath). There were no procedural complications recorded associated with the use of the catheter. B2+C lesions include 64% in the 6.5 SGC and 75% in the 6F guides.

In the 6.5F SGC group, 205 of the 211 patients were assessed at 3 months and radial occlusion occurred in 0 (0%) cases. In the 6F

Conclusion

We have shown that sheathless guiding catheters can replace conventional sheath-guide combinations for transradial PCI. Radial occlusion rates were very low and no access site complications were observed.