Safe and effective direct implantation of a new stent through 5 F. guiding catheters with delivery from the radial artery: initial results of a prospective registry.
OBJECTIVE
To evaluate the safety and efficacy of the direct implantation of a new stent via the radial artery through a 5 F. guiding catheter. Background advances in the design of stents and stent delivery systems have facilitated the performance of direct stenting and the use of thinner guiding catheters.


METHODS
This registry enrolled prospectively 125 patients (147 lesions, 20.4% AHA/ACC class B2/C) who underwent elective percutaneous coronary revascularization procedures for stable or unstable angina between November 2000 and March 2001.


RESULTS
Cannulation of the radial artery was attempted in 92.7% and was successful in 91.0% of cases. Direct stenting was successful in 88.7% of lesions and procedural success was 99.3%. In-hospital major adverse cardiac events occurred in 1.6% of cases (one death, one semi-urgent coronary artery bypass operation). The final rate of successful stent implantation through 5 F. guiding catheters was 96.7%. There were no access-site-related complications. Failure to cross the lesion occurred in 10% of attempts. At a mean follow-up of 7 +/- 2.8 months after discharge from hospital, 79% of patients had remained free of angina, and 89% had remained free of ischemic events.


CONCLUSIONS
Direct stenting with a new stent design was safe, effective, and could be accomplished through 5 F. guiding catheters with favorable long-term clinical outcomes.
Amsterdam Department of Interventional Cardiology-OLVG, Amsterdam, The Netherlands. A.J.J.IJsselmuiden@OLVG.NL
Alexander J J
AJ
IJsselmuiden
James M
JM
Cotton
Ton
T
Slagboom
Ron
R
van der Wieken
Ferdinand
F
Kiemeneij
Patrick W
PW
Serruys
GertJan
G
Laarman
D015906:Angioplasty, Balloon, Coronary / Q000379:methods*; D006328:Cardiac Catheterization / Q000379:methods*; D003324:Coronary Artery Disease / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000379:methods; D009426:Netherlands; D011446:Prospective Studies; D017534:Radial Artery / Q000601:surgery*; D012042:Registries; D015607:Stents; D016896:Treatment Outcome