Sheathless guiding catheter versus “slender” sheath/guiding catheter combination in acute coronary syndrome: a propensity-matched analysis of two downsized devices

2020 ◽  
Vol 41 (Supplement_2) ◽  
Author(s):  
T Isawa ◽  
K Horie ◽  
T Honda
Keyword(s):  
Acute Coronary Syndrome ◽  
Radial Artery ◽  
Coronary Intervention ◽  
Artery Occlusion ◽  
Access Site ◽  
Coronary Syndrome ◽  
Radial Artery Occlusion ◽  
Transradial Pci ◽  
Sheathless Guiding Catheter ◽  
Guiding Catheter

Abstract Purpose We investigated the differences between a sheathless guiding catheter and a Glidesheath slender/guiding catheter combination regarding access-site complications in percutaneous coronary intervention (PCI) for acute coronary syndrome (ACS). Methods We enrolled consecutive 1108 patients undergoing transradial primary PCI for ACS at our hospital using either a 7.5-Fr sheathless guiding catheter (Sheathless group) or a 7-Fr Glidesheath slender/7-Fr guiding catheter combination (Glidesheath group); 1:1 propensity score matching was performed, and 718 subjects (359 in each group) were included in the propensity-matched sample. Results Compared with the Sheathless group, the Glidesheath group had significantly less frequent ultrasound-diagnosed radial artery occlusion at 30 days (Sheathless: 4.7% vs. Glidesheath: 1.4%, p=0.015). No significant differences were observed in severe radial spasm (Sheathless: 1.4% vs. Glidesheath: 2.0%, p=0.77) or access-site bleeding (Sheathless: 9.8% vs. Glidesheath: 8.6%, p=0.70). Conclusion Thus, 7-Fr Glidesheath slender/7-Fr guiding catheter combination is clearly more advantageous than 7.5-Fr sheathless guiding catheters for decreased risk of radial artery occlusion in transradial PCI for ACS. “Sheathless” vs. “Glidesheath slender” Funding Acknowledgement Type of funding source: None

scholarly journals Slender Sheath/Guiding Catheter Combination vs. Sheathless Guiding Catheter for Acute Coronary Syndrome: A Propensity-Matched Analysis of the Two Devices

2020 ◽  
Vol 2020 ◽  
pp. 1-10 ◽  
Author(s):  
Tsuyoshi Isawa ◽  
Kazunori Horie ◽  
Taku Honda ◽  
Masataka Taguri ◽  
Norio Tada
Keyword(s):  
Acute Coronary Syndrome ◽  
Univariate Analysis ◽  
Coronary Intervention ◽  
Artery Occlusion ◽  
Access Site ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Transradial Pci ◽  
Sheathless Guiding Catheter ◽  
Guiding Catheter

A Glidesheath slender (Terumo, Tokyo, Japan) and a sheathless Eaucath guiding catheter (Asahi Intecc, Nagoya, Japan) are two major slender devices utilized in percutaneous coronary intervention (PCI). This study aimed to investigate the differences in access-site complications between these devices in PCI for acute coronary syndrome (ACS). A total of 1108 consecutive patients who underwent transradial PCI for ACS were enrolled. Transradial PCI was performed using either a 7-Fr Glidesheath slender/7-Fr guiding catheter combination (Glidesheath group) or a 7.5-Fr sheathless guiding catheter (Sheathless group); 1 : 1 propensity score matching was performed, and 728 patients (364 in each group) were included in the propensity-matched population. In the matched patients, univariate analysis revealed that the Glidesheath group had less radial artery occlusion (RAO) at 30 days (Glidesheath: 1.4% vs. Sheathless: 4.1%, odds ratio (OR) = 0.33, 95% confidence interval (CI) =  0.12–0.91, p=0.039), whereas no significant between-group differences were observed in severe radial spasm (Glidesheath: 1.4% vs. Sheathless: 1.9%, OR = 0.71, 95% CI = 0.23–2.22, p=0.58) or access-site major bleeding (Glidesheath: 1.4% vs. Sheathless: 1.6%, OR = 0.83, 95% CI = 0.26–2.71, p=1.00). Multivariate analysis revealed that the choice for Glidesheath was significantly associated with less RAO (OR = 0.32, 95% CI = 0.11–0.93, p=0.036). In conclusion, 7-Fr Glidesheath slender/7-Fr guiding catheter combination is obviously more advantageous than 7.5-Fr sheathless guiding catheters for decreased risk of RAO. The potential low risk of RAO in our findings supports the adoption of the 7-Fr Glidesheath slender sheath/7-Fr guiding catheter combination in transradial PCI for ACS.

Radial Artery Occlusion after Percutaneous Coronary Intervention through Transradial Approach

2021 ◽  
Vol 15 (8) ◽  
pp. 2246-2249
Author(s):  
Muhammad Asif Farooqi ◽  
Bilal Rafique Malik ◽  
Rehan Anwar
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Radial Artery ◽  
Coronary Intervention ◽  
Artery Occlusion ◽  
Good Opportunity ◽  
Transradial Approach ◽  
Coronary Syndrome ◽  
Percutaneous Coronary ◽  
Radial Artery Occlusion

Introduction: Radial artery occlusion may occur after percutaneous coronary intervention when done via transradial approach. The frequency of radial artery occlusion is almost nil in patients after PCI through transradial approach. Thus radial artery approach for PCI can be a good opportunity to conduct the procedure. Objective: To assess the frequency of radial artery occlusion after percutaneous coronary intervention through transradial approach in patients of acute coronary syndrome Material & Methods Study Design: Descriptive case study Settings: Department of Cardiology, Punjab Institute of Cardiology, Lahore. Duration: Six months i.e. 1st July 2020 to 31st December 2020. Data Collection: Total 100 patients who underwent PCI through transradial approach 6 months ago were studied. All the selected patients then underwent Doppler scan to assess patency of radial artery. Radial artery occlusion was confirmed by when there was reduced flow in radial artery as compared to the adjacent side artery Results: In this study, the mean age of patients was 54.56 ± 8.96 years. There were 43 (43%) males and 57 (57%) females. The frequency of radial artery occlusion in patients after PCI through transradial approach was seen in 3 (3%) of the patients. Conclusion: Results of this study demonstrates that the frequency of radial artery occlusion is almost nil in patients after PCI through transradial approach. Thus radial artery approach for PCI can be a good opportunity to conduct the procedure. Key Words: Radial artery Occlusion, Transradial approach, percutaneous coronary intervention, acute coronary syndrome

scholarly journals Radial artery occlusion after primary percutaneous coronary interventions performed using different radial approaches

2020 ◽  
Vol 24 (3S) ◽  
pp. 33
Author(s):  
R. V. Akhramovich ◽  
S. P. Semitko ◽  
A. V. Azarov ◽  
I. S. Melnichenko ◽  
A. I. Analeev ◽  
...  
Keyword(s):  
Acute Coronary Syndrome ◽  
Radial Artery ◽  
Artery Occlusion ◽  
Percutaneous Coronary Interventions ◽  
Radial Approach ◽  
Coronary Syndrome ◽  
Coronary Interventions ◽  
Percutaneous Coronary ◽  
Radial Artery Occlusion ◽  
Approach Group

<p><strong>Aim</strong>. The analyses of radial artery patency during hospitalisation in patients with acute coronary syndrome after percutaneous coronary interventions were performed using three options of radial approaches, i.e. traditional, classical and dorsopalmar distal radial approaches.</p><p><strong>Methods</strong>. Patients (n = 178) with acute coronary syndrome on whom endovascular procedure by the traditional and two options of distal radial approach were performed met the entry criteria. The classical distal radial approach was performed within an anatomic snuffbox in 65 patients (36.5%), and the dorsopalmar type was performed in 29 patients (16.3%); the traditional radial approach was performed in 84 patients (47.2%). On completion of the percutaneous coronary interventions and final radial artery angiography, hemostasis was performed with bandage application for 6 h. From <!-- x-tinymce/html-mce_16411137711604383874135 -->the 5<sup>th</sup> to the 7<sup>th</sup> day after intervention, examination, palpation and ultrasound duplex scan were performed in every patient.</p><p><strong>Results</strong>. Examination, palpation and ultrasound duplex scan performed from the 5th to 7th day after intervention revealed 3 cases (1.7%) of forearm radial artery occlusion (high type). All the 3 cases were in the traditional radial approach group. Access side radial artery occlusion (at the anatomical snuffbox and the dorsum of the plant [local type]) with saved blood supplement on the forearm was registered in the classical distal radial approach group in 4 cases (2.3%). There were no cases of access side radial artery occlusion in the dorsopalmar group.</p><p><strong>Conclusion</strong>. The use of the distal radial approach for primary percutaneous coronary intervention in patients with acute coronary syndrome definitely reduces the risk of radial artery occlusion of the forearm, whereas the dorsopalmar distal radial approach can be considered as a basic approach.</p><p>Received 11 May 2020. Revised 31 May 2020. Accepted 3 June 2020.</p><p><strong>Funding:</strong> The study did not have sponsorship.</p><p><strong>Conflict of interest:</strong> Authors declare no conflict of interest.</p><p><strong>Author contributions</strong><br />Conception and design: S.P. Semitko, R.V. Akhramovich<br />Data collection and analysis: R.V. Akhramovich, I.S. Melnichenko<br />Drafting the article: R.V. Akhramovich<br />Critical revision of the article: S.P. Semitko<br />Final approval of the version to be published: R.V. Akhramovich, S.P. Semitko, A.V. Azarov, I.S. Melnichenko, A.I. Analeev, I.E. Chernyisheva, A.A. Tretyakov, D.G. Ioseliani</p>

Patent haemostasis prevents radial artery occlusion in patients with an acute coronary syndrome

2017 ◽  
Vol 240 ◽  
pp. 78-81 ◽  
Author(s):  
Simon J. Wilson ◽  
Andrew Mitchell ◽  
Timothy J.M. Gray ◽  
Hoe Jun Loh ◽  
Nick L. Cruden
Keyword(s):  
Acute Coronary Syndrome ◽  
Radial Artery ◽  
Artery Occlusion ◽  
Coronary Syndrome ◽  
Radial Artery Occlusion

P4597Impact of operator experience with radial approach for clinical outcome on percutaneous coronary intervention in acute coronary syndrome performed with femoral artery access site

2019 ◽  
Vol 40 (Supplement_1) ◽  
Author(s):  
T Tokarek ◽  
A Dziewierz ◽  
K Plens ◽  
T Rakowski ◽  
M Zabojszcz ◽  
...  
Keyword(s):  
Percutaneous Coronary Intervention ◽  
Acute Coronary Syndrome ◽  
Radial Artery ◽  
Femoral Artery ◽  
Coronary Intervention ◽  
Access Site ◽  
Radial Approach ◽  
Coronary Syndrome ◽  
Radial Access ◽  
Percutaneous Coronary

Abstract Introduction Radial approach (RA) for percutaneous coronary intervention (PCI) is associated with reduced mortality and access site complications. The routine use of the RA in patients should be strongly considered, keeping in mind the learning curve associated with the technique. However, promotion of RA may interfere with the equally important goal of maintaining proficiency in the femoral approach (FA), which is essential in a variety of procedures as well as when RA fails. There is possible risk of higher rate of complications in PCI with FA performed by operators mainly using radial artery as access site. Purpose The aim of this study was to evaluate impact of experience and proficiency with RA for clinical outcomes on PCI via FA in “real-world” patients with acute coronary syndrome (ACS). Methods A total of 539 invasive cardiologists performing PCI in 151 invasive cardiology centers on the Polish territory between 2014 and 2017 were included in study analysis. Proficiency threshold has been set at >400 procedures during four consecutive years per individual operator. They were categorized to quartiles according to total volume of radial artery utilization during all PCIs. Procedures performed on patients with Killip-Kimball class IV on admission to catheterisation laboratory were excluded from analysis. Results The most of the operators performed >75% of all procedures via radial artery (326 (60.5%)), 112 (20.8%) used RA in 50–75% of cases, 67 (12.4%) in 25–50% of all PCIs and only 34 (6.3%) invasive cardiologist were using RA in less than 25% of all procedures. Mortality during PCI via FA was higher in group of invasive cardiologist with >75% of all procedures performed with radial access (>75% vs. 50–75% vs. 25–50% vs. <25%: 1.63% (±2.52%) vs. 0.93% (±1.05%) vs. 0.68% (±0.73%) vs. 0.31% (±0.40%); p=0.01). A trend towards higher rate of bleeding at the puncture site during PCI procedures with femoral artery were reported in groups of operators with higher expertise in RA (>75% vs. 50–75% vs. 25–50% vs. <25%: 0.43% (±1.09%) vs. 0.14% (±0.36%) vs. 0.21% (±0.45%) vs. 0.14% (±0.37%); p=0.09). Conclusions Higher experience in radial access might be linked to worse outcome in PCI via FA in ACS settings. Femoral artery is important vascular approach and should not be abandoned while learning procedures with radial artery utilization. Acknowledgement/Funding None

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