Sheathless guide catheter in transradial percutaneous coronary intervention for ST-segment elevation myocardial infarction.
OBJECTIVE
The aim of this study was to assess the safety and efficacy of sheathless guide catheters in transradial percutaneous coronary intervention (PCI) for ST-segment elevation myocardial infarction (STEMI).


BACKGROUND
Transradial PCI for STEMI offers significant clinical benefits, including a reduced incidence of vascular complications. As the size of the radial artery is small, the radial artery is frequently damaged in this procedure using large-bore catheters. A sheathless guide catheter offers a solution to this problem as it does not require an introducer sheath. However, the efficacy and safety of sheathless guide catheters remain to be fully determined in emergent transradial PCI for STEMI.


METHODS
Data on consecutive STEMI patients undergoing primary PCI at the Sendai Kousei Hospital between September 2010 and May 2013 were analyzed. The primary endpoint was the rate of acute procedural success without access site crossover. Secondary endpoints included door-to-balloon time, fluoroscopy time, volume of contrast, and radial artery stenosis or occlusion rate.


RESULTS
We conducted transradial PCI for 478 patients with STEMI using a sheathless guide catheter. Acute procedural success was achieved in 466 patients (97.5%). The median door-to-balloon time was 45 min (range, 15-317 min). The median fluoroscopy time was 16.4 min (range, 10-90 min). The median volume of contrast was 134 mL (range, 31-431 mL). Radial stenosis or occlusion developed in 14 (3.8%) of the 370 evaluable patients.


CONCLUSIONS
This study showed that use of a sheathless guide catheter taking a transradial approach was effective and safe in primary PCI for STEMI. © 2015 Wiley Periodicals, Inc.
Department of Cardiology, Sendai Kousei Hospital, Sendai, Miyagi, Japan.
Masaki
M
Miyasaka
Department of Cardiology, Sendai Kousei Hospital, Sendai, Miyagi, Japan.
Norio
N
Tada
Department of Cardiology, Sendai Kousei Hospital, Sendai, Miyagi, Japan.
Shigeaki
S
Kato
Division of Social Communication System for Advanced Clinical Research, Institute of Medical Science, University of Tokyo, Minato-Ku, Tokyo, Japan.
Masahiro
M
Kami
Department of Cardiology, Sendai Kousei Hospital, Sendai, Miyagi, Japan.
Kazunori
K
Horie
Department of Cardiology, Sendai Kousei Hospital, Sendai, Miyagi, Japan.
Taku
T
Honda
Department of Cardiology, Sendai Kousei Hospital, Sendai, Miyagi, Japan.
Kaname
K
Takizawa
Department of Cardiology, Sendai Kousei Hospital, Sendai, Miyagi, Japan.
Tatsushi
T
Otomo
Department of Cardiology, Sendai Kousei Hospital, Sendai, Miyagi, Japan.
Naoto
N
Inoue
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D062906:Cardiac Catheters; D017023:Coronary Angiography; D004562:Electrocardiography; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000295:instrumentation*; D017534:Radial Artery; D012189:Retrospective Studies; D000072657:ST Elevation Myocardial Infarction / Q000175:diagnosis / Q000601:surgery*; D013997:Time Factors; D016896:Treatment Outcome
STEMI; hydrophilic-coated catheter; transradial PCI; transradial approach