Korean Circ J.  2011 Mar;41(3):143-148. 10.4070/kcj.2011.41.3.143.

Feasibility of Transradial Coronary Intervention Using a Sheathless Guiding Catheter in Patients With Small Radial Artery

• Youn YJ
• Yoon J
• Han SW
• Lee JW
• Sung JK
• Ahn SG
• Kim JY
• Yoo BS
• Lee SH
• Choe KH

• KMID: 2225128
• DOI: http://doi.org/10.4070/kcj.2011.41.3.143

Abstract

BACKGROUND AND OBJECTIVES
Transradial coronary angiography and intervention are increasing in frequency due to lower major vascular access site complications and the potential for early mobilization. However, the small size of the radial artery (RA) is a major limitation of this technique. A sheathless guiding catheter (GC) has recently been introduced that has a 1-2 French smaller diameter compared with the corresponding introducer sheath. This catheter also has a hydrophilic coating along its entire length. We evaluated the feasibility of using a sheathless GC in patients who have small radial arteries.
SUBJECTS AND METHODS
The procedural results were evaluated in patients with small radial arteries (diameter <2.3 mm) who underwent transradial coronary intervention using a sheathless GC.
RESULTS
A total of 25 (male: 9) patients with 29 lesions were enrolled. The mean RA diameter was 1.81+/-0.26 mm. 44% of the patients had stable angina and 50.0% had acute coronary syndrome. The procedural success rate was 93.1%. Two patients (6.9%) had chronic total occlusive lesions that could not be crossed with a guide-wire despite good guiding support. An intravascular ultrasound could be used for all of the treated lesions. Multi-vessel intervention was performed in 29.2% of the patients. Two bifurcated lesions were treated with a kissing balloon technique, and one with a modified T-stenting technique. No catheter related complications were reported.
CONCLUSION
The use of a sheathless GC is feasible in patients with small radial arteries without catheter related complications.

Keyword

Coronary intervention; Radial artery; Vascular access

MeSH Terms

Acute Coronary Syndrome
Angina, Stable
Catheters
Coronary Angiography
Early Ambulation
Humans
Radial Artery

Figure

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  Fig. 1 Comparison of outer diameter (OD) between introducer sheath and sheathless guiding catheter (GC) (illustrated by author referred to SheathLess Eaucath® information brochure).

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  Fig. 2 The sheathless GC system (sheathless Eaucath, Asahi Intecc®, Japan). A: 6.5 Fr. hydrophilic GC illustrated with central dilator. B and C: Central dilator was inserted into GC and locked. D: GC with central dilator can be advanced along the 0.035" wire. GC: guiding catheter.

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