Feasibility and safety of a virtual 3-Fr sheathless-guiding system for percutaneous coronary intervention.
OBJECTIVE
To evaluate the feasibility and safety of a virtual 3-Fr system [5-Fr sheathless-guiding catheter (GC)] for percutaneous coronary intervention (PCI).


BACKGROUND
The use of miniaturized devices for PCI is gaining popularity because of increased patient comfort and decreased risk of access site complications.


METHODS
From July 2010 to December 2012, consecutive patients who underwent elective PCI (planned or ad hoc PCI) at our hospital were enrolled. PCI using the virtual 3-Fr system was attempted as our initial strategy, unless a 6-Fr or larger GC was considered to be suitable [lesions with heavy calcification, large (>2 mm) side branches, or chronic total occlusion].


RESULTS
Five hundred sixty-six patients underwent elective PCI during the study period, and 132 patients who met the criteria underwent PCI using the virtual 3-Fr system. Procedures using the virtual 3-Fr system were successful in 126 patients (95%); 111 (84%) were performed using the transradial approach, 110 (83%) were ad hoc procedures, and 45 (31%) were complex coronary lesions (type B2 or C). Six patients required conversion to a conventional 5- or 6-Fr sheath and catheter system. No intraoperative complications occurred, and radial artery patency was achieved in all patients who underwent transradial procedures.


CONCLUSIONS
PCI using the virtual 3-Fr system is a feasible and viable alternative to conventional procedures that use a sheath and GC in appropriately selected patients. This small-caliber system may minimize endovascular trauma, particularly during transradial coronary procedures.
Cardiovascular Center, Shiroyama Hospital, Habikino City, Osaka, 583-0872, Japan.
Daisuke
D
Tonomura
Yoshihisa
Y
Shimada
Kentaro
K
Yano
Kazato
K
Ito
Kosuke
K
Takehara
Naoto
N
Kino
Keiichi
K
Furubayashi
Toshiya
T
Kurotobi
Takao
T
Tsuchida
Hitoshi
H
Fukumoto
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000000981:diagnostic imaging / Q000601:surgery*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D008904:Miniaturization; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation*; D017534:Radial Artery; D012189:Retrospective Studies; D016896:Treatment Outcome; D014584:User-Computer Interface
coronary artery disease; interventional devices; percutaneous coronary intervention