Simultaneous dual vascular access site for the treatment of coronary artery bifurcation lesions by complex 2-stent technique.
OBJECTIVE
To propose an original approach based on simultaneous dual vascular access site (DAS) using 2 small-size guiding catheters to easily perform complex 2-stent techniques for bifurcation coronary lesions (BL).


BACKGROUND
Simultaneous kissing stenting and classic crush technique require large 7 or 8Fr guiding catheters leading to large amounts of contrast medium, vascular access site complications, and sometimes frictions or criss-cross of the 2-stent delivery systems.


METHODS
DAS was used in 30 patients with BL (11 radio-radial, 16 radio-femoral, and 3 femoro-femoral). Among 60 guiding catheters, the size was 5Fr in 28, 6Fr in 30, and 7Fr in 2 cases of double adjacent BL. When 2 different size catheters were used, contrast medium injections were done using the smallest size catheter. DAS patients were compared with a group of 30 BL patients treated using a single femoral vascular access site (SAS) with 7 or 8Fr catheters.


RESULTS
Success rate was 100% in all patients. Contrast volume used was smaller in DAS than in SAS patients (277 ± 156 cc vs. 380 ± 165 cc,P = 0.01). No vascular access site complication occurred in the sub-group of the 11 DAS radio-radial patients. Postintervention hospitalization duration was shorter in DAS than in SAS (1.9 ± 2 vs. 2.8 ± 2 days,P = 0.048).


CONCLUSIONS
DAS allows to successfully perform complex stenting technique of BL using small-size guiding catheters leading to decreased contrast medium volume, decreased vascular access site complications rates, and shortened hospitalization duration.
Division of Cardiology, University of Saint Etienne, Saint Etienne, France. isaaz@univ-st-etienne.fr
Karl
K
Isaaz
Norbert
N
Mayaud
Michel
M
Lamaud
Amélie
A
Raynaud
Alexis
A
Cerisier
Mohammed Hassan
MH
Sabry
Laure
L
Richard
Hazem
H
Khamis
Ahmad
A
Abd-Alaziz
Antoine
A
DA Costa
D000368:Aged; D000704:Analysis of Variance; D006328:Cardiac Catheterization / Q000379:methods*; D003287:Contrast Media; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000628:therapy*; D003331:Coronary Vessels / Q000473:pathology*; D005260:Female; D006801:Humans; D008297:Male; D012189:Retrospective Studies; D015607:Stents; D013997:Time Factors; D062666:Vascular Access Devices
D003287:Contrast Media