[One center's experience of coronary angioplasty with a 5 French catheter guide by a femoral approach at the same time as coronary angiography].
The object of this study was to assess the feasibility of so-called ad hoc 5 F percutaneous transluminal coronary angioplasty (PTCA). This monocentric register included 200 consecutive procedures (233 lesions) of 5F PTCA by a femoral approach after a bolus of standard heparin (50 to 70 IU/kg). The population included 15.4% of stable angina, 29.4% of unstable angina, 11% acute phase, 13.5% post-revascularisation angina and 30.7% post-infarction cases. A successful procedure was defined as a good angiographic result without ischaemic complications. A failed 5F procedure was defined by the need to fall back on a 6F PTCA. The peripheral vascular complications were recorded. The lesions were stented in 77.4% of cases including 13.4% of direct stenting. There were 200 successful procedures (87%). The failures (N = 26) were mainly explained by the inability to cross chronic obstruction (N = 11). The ischaemic complications included 2 coronary bypasses (2 retrograde dissections of the left anterior descending artery) and 7 enzymatic increases without ECG changes. Fall back to 6F PTCA was required in 4 cases (1.7%) always because of the instability of the 5F catheter guide before the procedure. The quality of coronary contrast was estimated to be good. The vascular complication rate was low with 2% of communicating haematomas (N = 4). Therefore, 5F PTCA is feasible with failure and complication rates comparable to those reported with catheters of larger dimensions. One of its principal advantages is "ad hoc" angioplasty after 5F coronary angiography.
Brasselet
C
C
Département de cardiologie, CHU Robert-Debré, 51092 Reims. camille.brasselet@wanadoo.fr
Metz
D
D
Perotin
S
S
Maillier
B
B
Tassan-Mangina
S
S
Deschildre
A
A
Bonfils
L
L
Jennessaux
C
C
Blaise
C
C
Elaerts
J
J
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000787:Angina Pectoris / Q000628:therapy*; D000789:Angina, Unstable / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D000925:Anticoagulants / Q000627:therapeutic use; D006328:Cardiac Catheterization / Q000295:instrumentation* / Q000379:methods; D017023:Coronary Angiography; D001026:Coronary Artery Bypass; D005260:Female; D006493:Heparin / Q000627:therapeutic use; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000628:therapy*; D009204:Myocardial Revascularization / Q000379:methods; D011183:Postoperative Complications; D012189:Retrospective Studies
D000925:Anticoagulants; D006493:Heparin
Expérience monocentrique de l'angioplastie coronaire par cathéter guide 5 French menée par voie fémorale dans le même temps que l'examen coronarographique.