title: Comparison of novel 6.5 Fr sheathless guiding catheters versus 5 Fr guiding catheters for transradial coronary intervention.
abstract: OBJECTIVE
  To assess the safety and efficacy of a novel sheathless (SH) 6.5 Fr (French) hydrophilic-coated guiding catheter (GC) compared to the standard 5 Fr GCs in transradial coronary interventions (TRI).
  
  
  RESULTS
  Patients undergoing TRI with 6.5 Fr SH or 5 Fr GCs were included. Baseline characteristics and in-hospital outcomes were recorded. Primary endpoints were procedural success and presence of radial pulse at discharge. Secondary endpoints were successful GC support, in-hospital adverse events, access-site complications, procedural duration and contrast load. There were 269 patients with 146 procedures in each group. The SH GC group had more non-ST elevation MI, in-stent restenosis, high-risk and bifurcation lesions. Procedural success in both arms was 95.2%. One patient in each group (0.7%) experienced radial artery occlusion (RAO) after TRI, without clinical sequelae. One access-site haematoma and one minor stroke occurred in the 5 Fr group (none in the SH group, both p=ns). Mean procedure time (52±21 vs. 45±21 minutes, p=0.004) and contrast load (160±45 ml vs. 140±45 ml, p=0.003) were greater in the SH group.
  
  
  CONCLUSIONS
  Both 6.5 Fr SH GCs and 5 Fr GCs achieved high procedural TRI success with low RAO rates. The SH GC eliminated the disadvantages of the 5 Fr GC whilst maintaining the advantage of low RAO rates, and may become the GC of choice in TRI.
authors.affiliation: Department of Cardiology, National Heart Center Singapore, Singapore. paul.chiam.t.l@nhc.com.sg
authors.forename: Paul T L
authors.initials: PT
authors.lastname: Chiam
authors.forename: Bing
authors.initials: B
authors.lastname: Liu
authors.forename: Aaron S L
authors.initials: AS
authors.lastname: Wong
authors.forename: Philip E H
authors.initials: PE
authors.lastname: Wong
authors.forename: Soo-Teik
authors.initials: ST
authors.lastname: Lim
authors.forename: Tian-Hai
authors.initials: TH
authors.lastname: Koh
authors.forename: Victor Y T
authors.initials: VY
authors.lastname: Lim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017130:Angioplasty / Q000295:instrumentation*; D006328:Cardiac Catheterization / Q000295:instrumentation*; D057785:Catheters; D003327:Coronary Disease / Q000628:therapy*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D017534:Radial Artery