title: Five French versus 6 French PCI: a case control study of efficacy, safety and outcome.
abstract: We report our experience of percutaneous coronary intervention (PCI) with 5 French (Fr) guiding catheters in a retrospective analysis of consecutive cases undergoing ad hoc PCI. Results were compared with a cohort of 6 Fr PCI cases matched for age, sex and operator over the same study period. A total of 210 patients (311 lesions) underwent PCI using 5 Fr guiding catheters and 174 matched patients (300 lesions) underwent PCI with 6 Fr guiding catheters. Multivessel PCI was performed in 18% of patients in the 5 Fr group and in 26% of the 6 Fr group (p = 0.046). There was no difference in clinical, angiographic or procedural characteristics between groups. Technical success rate was superior in the 5 Fr group compared with the 6 Fr (99% versus 95%; p = 0.03). The rate of stent implantation did not differ and the 5 Fr guiding catheter did not prohibit the use of large or long stents/balloons. Failure of 5 Fr PCI in 3 cases was not due to inadequate guiding catheter support. In-hospital major adverse cardiac events (MACE) and serious femoral complications were rare and at 6-month follow-up did not differ between groups. However, compared with 6 Fr PCI, procedure time and contrast medium usage was significantly less in the 5 Fr group (contrast: 274 +/- 101 ml versus 313 +/- 124 ml; p = 0.0008; fluoroscopy time: 16 +/- 9 minutes versus 19 +/- 12 minutes; p = 0.006). We conclude that the use of 5 Fr guiding catheters is effective and safe in unselected patients undergoing PCI and may even confer certain advantages. The 5 Fr approach can be recommended for routine interventional practice.
authors.affiliation: Swiss Cardiovascular Center, University Hospital, 3010-Bern, Switzerland. bernhard.meier@insel.ch
authors.forename: Roby D
authors.initials: RD
authors.lastname: Rakhit
authors.forename: Christoph
authors.initials: C
authors.lastname: Matter
authors.forename: Stephan
authors.initials: S
authors.lastname: Windecker
authors.forename: Ali R
authors.initials: AR
authors.lastname: Garachemani
authors.forename: Christian
authors.initials: C
authors.lastname: Seiler
authors.forename: Franz R
authors.initials: FR
authors.lastname: Eberli
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects* / Q000295:instrumentation*; D016022:Case-Control Studies; D016009:Chi-Square Distribution; D003327:Coronary Disease / Q000628:therapy*; D004869:Equipment Safety; D005260:Female; D006488:Hemostasis, Surgical / Q000379:methods; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D016896:Treatment Outcome