Coronary intervention with 4-French catheters.
OBJECTIVE
We sought to determine whether 4-Fr percutaneous coronary intervention (PCI) is associated with technical difficulties that might have an unfavorable impact on procedural parameters.


BACKGROUND
Four-Fr PCI is often associated with difficulties in catheter manipulation, which may lead to greater time consumption and increased dye usage when compared with PCI employing larger guiding catheters.


METHODS
From July 2007 to March 2009, 62 patients underwent 4-Fr PCI. Procedural characteristics were compared between patients who underwent 4-Fr PCI in 2007 (early phase: 31 lesions in 26 patients) and those underwent in 2008 or later (later phase: 40 lesions in 36 patients).


RESULTS
Ad-hoc coronary intervention (3% vs. 23%, P < 0.05) and deep-vessel intubation (46% vs. 91%, P < 0.05) were observed less frequently in the late phase than the early phase. Fluoroscopy time (8 +/- 6 min vs. 17 +/- 15 min, P < 0.05) and the amount of contrast dye used (64 +/- 33 mL vs. 90 +/- 46 mL, P < 0.05) were significantly reduced in the late phase than the early phase. No access site-related complications were observed in patients in either phase.


CONCLUSIONS
The performance of 4-Fr PCI requires a certain learning curve, following which a reduction in fluoroscopy time and use of contrast dye may be achieved. This improvement in procedural parameters and the low incidence of access site-related complications might allow 4-Fr PCI to serve as a minimally invasive approach for the treatment of coronary artery diseases.
Takeshita
Satoshi
S
Department of Cardiology and Catheterization Laboratory, Shonan Kamakura General Hospital, Kamakura, Japan. stake@muse.ocn.ne.jp
Tanaka
Shinji
S
Saito
Shigeru
S
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation*; D016009:Chi-Square Distribution; D002983:Clinical Competence; D003287:Contrast Media; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D004867:Equipment Design; D005260:Female; D005471:Fluoroscopy; D006801:Humans; D008297:Male; D008875:Middle Aged; D008904:Miniaturization; D015641:Radiography, Interventional; D012189:Retrospective Studies; D015607:Stents; D016896:Treatment Outcome
D003287:Contrast Media