Sheathless transradial intervention using standard guide catheters

Catheterization and Cardiovascular Interventions

Our aim was to report our preliminary experience performing complex transradial interventions using a sheathless technique with standard large bore nonhydrophilic guiding catheters.

A major limitation of transradial percutaneous coronary intervention (PCI) is the inability to use large guides because of the relatively small size of the radial artery.

We identified consecutive patients who had transradial PCI between September 2009 and March 2010 using large-bore guides (7 or 8 Fr) with a sheathless technique.

Ten patients were identified (90% men, mean age 68.8 ± 9.8 years). Indications for PCI were stable angina (60%) and acute coronary syndrome (47wQbNPTDJp9hMYdvogK2hAUiHsGeiybwaWe36bwtRQ3UTpYV7YuZ8FV5j9nauFCWwcjM6dTzpL5s2N79Rp5unwdMvc8ZKUOne patient had a chronic total occlusion, one had a saphenous vein bypass graft lesion requiring filter wire placement prior to intervention, and one patient required rotational atherectomy. In the majority of patients (60%) a 7-Fr guiding catheter was used for the intervention; 8-Fr guide catheters were used four patients. PCI was unsuccessful in one vessel; this was a completely occluded obtuse marginal which could not be crossed. There were no radial artery access site complications and in no case was cross-over to a femoral artery access site required. One minor coronary complication occurred.

CONCLUSIONS: Sheathless transradial PCI using standard large-bore guiding catheters is a safe and effective method for treatment of complex lesions

Volume 76, Issue 7, pages 911–916, 1 December 2010