title: Outpatient coronary angiography with 4 French catheters.
abstract: The early 4 French (Fr), pre-formed, Judkins coronary catheters had unsatisfactory maneuverability due to reduced torque stability. Technical innovations have led to improved 4 Fr catheters. This prospective study evaluates the safety and feasibility of the 4 Fr Quick Care Infinity catheter (Cordis, Miami, Florida). Within a series of 2,366 patients investigated for suspected coronary artery disease, 302 were selected for outpatient treatment according to the guidelines for outpatient catheterization. Fluoroscopy time was 2.8 +/- 2.5 minutes. It was not necessary to change to larger catheters in any patient. After sheath removal, hemostasis was achieved within 14 +/- 8 minutes. Strict bed rest lasted 181 +/- 65 minutes; patients were discharged 303 +/- 76 minutes after arterial puncture. Sixteen of the 302 patients (5.3%; 95% confidence interval (CI): 3.1-7.9%) changed to inpatient treatment for reasons unrelated to the arterial access. Eight patients (2.6%; CI: 1.1-5.1%) required one night of hospitalization for control of hematoma. The following morning, vessel murmur, pain, and large hematoma (more than 10 cm diameter) occurred in 1 (0.3%), 6 (2.0%), and 6 (2.0%) patients, respectively. This necessitated hospital admission in 2 patients (0.7%; CI: 0.0-2.3%) for up to 2 days. Major entry site complications requiring blood transfusion or surgery did not occur (CI: 0.0-0.3%). It was concluded that outpatient catheterization for coronary artery disease using the new 4 French catheters is feasible and can be rapidly and safely performed in a selected patient population.
authors.affiliation: Department of Interventional Cardiology, St. Georg Hospital, Leipzig, Germany.
authors.forename: W
authors.initials: W
authors.lastname: Burger
authors.forename: J
authors.initials: J
authors.lastname: Gärtner
authors.forename: G D
authors.initials: GD
authors.lastname: Kneissl
authors.forename: W K
authors.initials: WK
authors.lastname: Rothe
authors.forename: A
authors.initials: A
authors.lastname: Hartmann
mesh_terms: D000328:Adult; D000368:Aged; D006328:Cardiac Catheterization / Q000295:instrumentation* / Q000379:methods; D002985:Clinical Protocols; D017023:Coronary Angiography / Q000295:instrumentation* / Q000379:methods; D005240:Feasibility Studies; D005260:Female; D005263:Femoral Artery; D006764:Hospitals, Community; D006801:Humans; D008297:Male; D008875:Middle Aged; D008904:Miniaturization; D010043:Outcome and Process Assessment, Health Care; D010044:Outpatient Clinics, Hospital; D017410:Practice Guidelines as Topic; D011446:Prospective Studies; D012449:Safety; D013997:Time Factors