Percutaneous coronary intervention using a novel 4-French coronary accessor.
BACKGROUND
Percutaneous coronary intervention (PCI) using a guiding catheter with small diameters may have a favorable impact on vascular access complications and patient morbidity. Here, we report the initial results of PCI using a 4-Fr coronary accessor.


METHODS
A total of 31 patients underwent 4-Fr PCI. Exclusion criteria for 4-Fr PCI were (1) lesions associated with large side branches requiring wire protection or kissing balloon technique and (2) planned use of angioplasty devices which were not compatible with 4-Fr catheter.


RESULTS
A total of 36 lesions, including 4 chronic total occlusions (CTO), were treated. Access sites included radial artery in 19 patients (61%), brachial artery in 8 (26%), and femoral artery in 4 (13%). Four-Fr PCI was successful in 34 of 36 lesions (94%) in 29 of 31 patients (94%). One of the two unsuccessful patients was a case of CTO, and the other a case of tortuous right coronary artery. In both, crossover to a 6-Fr PCI was necessary. Among successfully treated 34 lesions of the 29 patients, coronary stents were deployed in 30 lesions (88%). There were no stent dislodgements or inadequate contrast opacification. No access-site related complications including radial artery occlusion were observed.


CONCLUSIONS
PCI with a 4-Fr coronary accessor is a viable alternative to the use of larger guide catheters. The advent of 4-Fr stent delivery system may afford a less invasive approach for the treatment of patients with coronary artery disease.
Department of Cardiology, National Cardiovascular Center, Suita, Japan. stake@muse.ocn.ne.jp
Satoshi
S
Takeshita
Takaaki
T
Shiono
Ayumu
A
Takagi
Takenari
T
Ito
Shigeru
S
Saito
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000295:instrumentation* / Q000379:methods; D002406:Catheterization, Peripheral / Q000295:instrumentation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged