title: Feasibility and safety of transradial coronary interventions using a 6.5-F sheathless guiding catheter in patients with small radial arteries.
abstract: OBJECTIVE
  This study investigated the feasibility and the safety of using a 6.5-French sheathless guide catheter in patients with small radial arteries.
  
  
  BACKGROUND
  The small size of radial arteries is a limitation of transradial coronary intervention. A new sheathless guiding catheter with a diameter almost 2-Fr smaller than conventional sheaths and a full-length hydrophilic coating has been introduced.
  
  
  METHODS
  A total of 148 patients from three French hospitals were consecutively enrolled from March 2009 to February 2012. They underwent transradial approach (TRA) for percutaneous coronary interventions (PCI) using the 6.5-F ASAHI sheathless Eaucath guiding catheter system.
  
  
  RESULTS
  Among the 148 patients enrolled, 95 were females (64%), and 183 lesions were treated. Procedural success rate was 100%. Thirteen patients (9%) underwent same-procedure multivessel interventions for the right and left coronary artery. Among the group of 46 patients undergoing bifurcation PCI, 35 (76%) bifurcated lesions were treated with a kissing balloon technique, one patient had a saphenous vein bypass graft lesion requiring filter wire placement prior to intervention, nine (6.1%) patients required rotational atherectomy, thrombus-aspiration catheters were used in 19 (12.8%) patients, fractional flow reserve (FFR)-guided PCI in 10 (6.7%) patients, alcohol septal ablation in three (2%) patients. Ten (6.7%) cases of chronic total occlusion were successfully treated in nine (6.1%) patients using the hydrophilic catheter. No radial artery site complications was noted.
  
  
  CONCLUSIONS
  The use of sheathless guiding catheters is a safe, effective method for PCI via TRA in small radial arteries without catheter-related complications.
authors.affiliation: Department of Interventional Cardiology, Hôpital Européen de Paris, La Roseraie, Aubervilliers, France.|Department of Interventional Cardiology, Institut Cardiovasculaire Paris Sud, Générale de Santé, Hôpital Privé Jacques Cartier, Massy, France.
authors.forename: Radi
authors.initials: R
authors.lastname: Cheaito
authors.affiliation: Department of Interventional Cardiology, Hôpital Européen de Paris, La Roseraie, Aubervilliers, France.|Department of Interventional Cardiology, Institut Cardiovasculaire Paris Sud, Générale de Santé, Hôpital Privé Jacques Cartier, Massy, France.
authors.forename: Hakim
authors.initials: H
authors.lastname: Benamer
authors.affiliation: Department of Interventional Cardiology, Institut Cardiovasculaire Paris Sud, Générale de Santé, Hôpital Privé Jacques Cartier, Massy, France.
authors.forename: Thomas
authors.initials: T
authors.lastname: Hovasse
authors.affiliation: Department of Interventional Cardiology, Hôpital Européen de Paris, La Roseraie, Aubervilliers, France.
authors.forename: Amine
authors.initials: A
authors.lastname: Tritar
authors.affiliation: Department of Interventional Cardiology, Institut Cardiovasculaire Paris Sud, Générale de Santé, Hôpital Privé Jacques Cartier, Massy, France.
authors.forename: Fouad
authors.initials: F
authors.lastname: Hage
authors.affiliation: Department of Interventional Cardiology, Institut Cardiovasculaire Paris Sud, Générale de Santé, Hôpital Privé Claude Galien, Quincy sous Sénart, France.
authors.forename: Philippe
authors.initials: P
authors.lastname: Garot
authors.affiliation: Department of Interventional Cardiology, Institut Cardiovasculaire Paris Sud, Générale de Santé, Hôpital Privé Jacques Cartier, Massy, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Lefèvre
authors.affiliation: Department of Interventional Cardiology, Institut Cardiovasculaire Paris Sud, Générale de Santé, Hôpital Privé Claude Galien, Quincy sous Sénart, France.
authors.forename: Thierry
authors.initials: T
authors.lastname: Unterseeh
authors.affiliation: Department of Interventional Cardiology, Institut Cardiovasculaire Paris Sud, Générale de Santé, Hôpital Privé Jacques Cartier, Massy, France.
authors.forename: Bernard
authors.initials: B
authors.lastname: Chevalier
authors.affiliation: Department of Interventional Cardiology, Institut Cardiovasculaire Paris Sud, Générale de Santé, Hôpital Privé Jacques Cartier, Massy, France.
authors.forename: Marie-Claude
authors.initials: MC
authors.lastname: Morice
authors.affiliation: Department of Interventional Cardiology, Hôpital Européen de Paris, La Roseraie, Aubervilliers, France.|Department of Interventional Cardiology, Institut Cardiovasculaire Paris Sud, Générale de Santé, Hôpital Privé Jacques Cartier, Massy, France.
authors.forename: Yves
authors.initials: Y
authors.lastname: Louvard
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D062906:Cardiac Catheters; D017023:Coronary Angiography / Q000379:methods*; 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; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D017534:Radial Artery; D012189:Retrospective Studies
keywords: PCI; complex coronary lesion; radial spasm; sheathless guiding catheter; small radial arteries; transradial approach