Sheathless guide catheter coronary intervention via radial artery: single-center experience with 9658 procedures.
OBJECTIVE
To evaluate the efficacy and safety of transradial coronary intervention (TRI) using a sheathless guide catheter (sheathless TRI) in a large, retrospective, single-center study.


BACKGROUND
The sheathless guide catheter was designed to be inserted without an introducer sheath to decrease stress to the radial artery. Although the sheathless guide catheter has some potential limitations, such as its procedural complexity or the risk of coronary ostial dissection, no large studies have been reported.


METHODS
We retrospectively investigated all TRIs performed at Sendai Kousei Hospital from January 2004 to December 2013.


RESULTS
Out of a total of 12,617 percutaneous coronary interventions (PCIs), sheathless TRIs were performed in 9658 cases (76.5%) and TRIs using a conventional sheath (sheath TRI) were performed in 1070 cases (8.5%). Procedural success was achieved in 98.81% of sheathless TRIs and 96.82% of sheath TRIs (P<.001); after propensity matching, the success rate was 98.9% in sheathless TRIs and 97.6% in sheath TRIs (P=.01). The conversion of the guide catheter system occurred in 0.40% of sheathless TRIs and 0.28% in sheath TRIs (P=.54). Coronary ostial dissection occurred in 0.26% of sheathless TRIs and 0.47% in sheath TRIs (P=.22).


CONCLUSIONS
Sheathless TRI was utilized in the majority of cases, and the propensity-matched procedural success was similar but statistically higher as compared with sheath TRI. Complications were rare and equivalent to sheath TRI. Sheathless TRI is effective and safe as an initial PCI technique after the consideration of its benefits and limitations.
Department of Cardiology, Sendai Kousei Hospital, 4-15 Hirosemachi Aoba Sendai, Miyagi 980-0873, Japan. noriotada@hotmail.com.
Norio
N
Tada
Kaname
K
Takizawa
Mitsuru
M
Kahata
Masataka
M
Taguri
Tatsushi
T
Ootomo
Naoto
N
Inoue
D000368:Aged; D002406:Catheterization, Peripheral / Q000295:instrumentation*; D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000601:surgery*; D004867:Equipment Design; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D017534:Radial Artery; D012189:Retrospective Studies; D013997:Time Factors; D016896:Treatment Outcome