title: Percutaneous coronary intervention without use of guiding catheters for extreme downsizing: the Emperor's new clothes technique.
abstract: A 72-year-old male with effort angina pectoris and old myocardial infarction underwent percutaneous coronary intervention (PCI). A 4 Fr sheath was inserted in the radial artery. After diagnostic angiography, a guidewire was inserted from the diagnostic catheter. The diagnostic catheter is removed, and the distal tip of the guidewire remains in the coronary artery. Intravascular ultrasound (IVUS) could be performed via the 4 Fr sheath without guiding catheters. IVUS-guide PCI was successfully performed with 4 Fr sheath, although IVUS requires at least a 5 Fr or larger system. This technique is called "The Emperor's New Clothes Technique" because PCI is performed as if an invisible guiding catheter was being used.
authors.affiliation: Department of Cardiology, Aomori Prefectural Central Hospital, 2-1-1 Higashi-Tsukurimichi, Aomori City 030-8553, Japan. yoshimachi-circ@umin.ne.jp
authors.forename: Fuminobu
authors.initials: F
authors.lastname: Yoshimachi
authors.forename: Yoshihisa
authors.initials: Y
authors.lastname: Aida
authors.forename: Dai
authors.initials: D
authors.lastname: Miura
authors.forename: Ryudo
authors.initials: R
authors.lastname: Kawahara
authors.forename: Shinichi
authors.initials: S
authors.lastname: Abe
authors.forename: Taro
authors.initials: T
authors.lastname: Suchi
mesh_terms: D000368:Aged; D000787:Angina Pectoris / Q000209:etiology; D002404:Catheterization / Q000295:instrumentation; D017023:Coronary Angiography; D023921:Coronary Stenosis / Q000150:complications / Q000628:therapy*; D006801:Humans; D008297:Male; D009203:Myocardial Infarction / Q000209:etiology; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation* / Q000379:methods*; D017534:Radial Artery; D018084:Ultrasonography, Interventional / Q000379:methods