Sheathless transradial intervention using standard guide catheters.

From AM, Gulati R, Prasad A, Rihal CS. The Division of Cardiovascular Diseases, Mayo Clinic College of Medicine and Mayo Foundation Rochester, Minnesota.

OBJECTIVES: Our aim was to report our preliminary experience performing complex transradial interventions using a sheathless technique with standard large bore non-hydrophilic guiding catheters.

BACKGROUND: A major limitation of transradial PCI is the inability to use large guides because of the relatively small size of the radial artery.

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

RESULTS: Ten patients were identified (90% male, mean age 68.8 +/- 9.8 years). Indications for PCI were stable angina (60%) and acute coronary syndrome (40%). Treatment was attempted on 15 vessels. Bifurcation lesions were present in 6 patients. One 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 utilized for the intervention; 8 Fr guide catheters were used 4 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

Catheter Cardiovasc Interv. 2010 Sep 7. [Epub ahead of print]