Sheathless transradial intervention using standard guide catheters.
OBJECTIVE
Our aim was to report our preliminary experience performing complex transradial interventions using a sheathless technique with standard large bore nonhydrophilic guiding catheters.


BACKGROUND
A major limitation of transradial percutaneous coronary intervention (PCI) is the inability to use large guides because of the relatively small size of the radial artery.


METHODS
We identified consecutive patients who had transradial PCI between September 2009 and March 2010 using large-bore guides (7 or 8 Fr) with a sheathless technique.


RESULTS
Ten patients were identified (90% men, mean age 68.8 ± 9.8 years). Indications for PCI were stable angina (60%) and acute coronary syndrome (40%). Treatment was attempted on 15 vessels. Bifurcation lesions were present in six patients. One patient had a chronic total occlusion, one had a saphenous vein bypass graft lesion requiring filter wire placement prior to intervention, and one patient required rotational atherectomy. In the majority of patients (60%) a 7-Fr guiding catheter was used for the intervention; 8-Fr guide catheters were used four patients. PCI was unsuccessful in one vessel; this was a completely occluded obtuse marginal which could not be crossed. There were no radial artery access site complications and in no case was cross-over to a femoral artery access site required. One minor coronary complication occurred.


CONCLUSIONS
Sheathless transradial PCI using standard large-bore guiding catheters is a safe and effective method for treatment of complex lesions.
From
Aaron M
AM
The Division of Cardiovascular Diseases, Mayo Clinic College of Medicine and Mayo Foundation, Rochester, Minnesota 55905, USA.
Gulati
Rajiv
R
Prasad
Abhiram
A
Rihal
Charanjit S
CS
D000368:Aged; D000369:Aged, 80 and over; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000295:instrumentation / Q000379:methods; D057785:Catheters; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000628:therapy*; D004867:Equipment Design; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D017534:Radial Artery; D013997:Time Factors; D016896:Treatment Outcome