Erratum to “Slender Sheath/Guiding Catheter Combination vs. Sheathless Guiding Catheter for Acute Coronary Syndrome: A Propensity-Matched Analysis of the Two Devices”

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

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

Journal of Interventional Cardiology ◽

10.1155/2020/8216831 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10 ◽

Cited By ~ 1

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.

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TCT-282 Feasibility and Safety of Transradial Coronary Intervention Using 6.5 French Sheathless Guiding Catheter during ST-segment Elevation Acute Coronary Syndrome (STEACS) in Patients with Small Radial Artery: A Multi Center Registry.

Journal of the American College of Cardiology ◽

10.1016/j.jacc.2013.08.1018 ◽

2013 ◽

Vol 62 (18) ◽

pp. B92

Author(s):

Radi Cheaito ◽

Hakim Benamer ◽

Bernard Chevalier ◽

Youssef Derraz ◽

Philippe Garot ◽

...

Keyword(s):

Acute Coronary Syndrome ◽

Radial Artery ◽

Coronary Intervention ◽

St Segment Elevation ◽

Coronary Syndrome ◽

St Segment ◽

Elevation Acute Coronary Syndrome ◽

Sheathless Guiding Catheter ◽

Guiding Catheter

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A new iteration for the single-access large-bore technique during impella supported complex and high-risk coronary intervention: a case report

European Heart Journal - Case Reports ◽

10.1093/ehjcr/ytab428 ◽

2021 ◽

Author(s):

Marco Araco ◽

Angelo Quagliana ◽

Giovanni Pedrazzini ◽

Marco Valgimigli

Keyword(s):

High Risk ◽

Coronary Intervention ◽

Left Ventricular ◽

Bleeding Complications ◽

Single Access ◽

Arterial Access ◽

Coronary Syndrome ◽

Sheathless Guiding Catheter ◽

Access Technique ◽

Guiding Catheter

Abstract BACKGROUND Complex and high-risk coronary intervention (CHIP-PCI) and PCI in cardiogenic shock complicating acute coronary syndrome is increasingly performed under mechanical circulatory support—so called protected PCI. Among the available options, Impella CP heart pump (ABIOMED) is percutaneously inserted over the femoral artery and typically requires a second arterial access to perform PCI, which further enhances the risk of vascular and bleeding complications. The single-access technique allows Impella CP placement and PCI performance through the same vascular access. When a 7-french system is desirable, only a long and entirely hydrophilic coated sheath has been previously used, which is not available in Europe. CASE SUMMARY A 85-year-old patient admitted with NSTE-ACS, severely reduced left ventricular function and three-vessel coronary artery disease underwent single access CHIP-PCI under Impella CP support. After a failed attempt to insert a standard 7-french long femoral sheath alongside the Impella catheter, we successfully introduced a 7.5-french sheathless guiding catheter and delivered the planned percutaneous treatment with the benefits conferred by a 7-french—rather than 6 - lumen catheter, without the need for an additional arterial access. DISCUSSION This is, to the best of our knowledge, the first case of CHIP-PCI performed under Impella support utilizing the single-access technique with a 7.5-french sheathless guiding catheter. Beyond advantages of the single-access technique in sparing time and avoiding vascular complications associated with gaining a second arterial access, the lower outer diameter of the sheathless catheter compared with standard 7-french sheaths may allow improved limb perfusion and lower chance of interference with the impella CP catheter.

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