title: Impact of a single universal guiding catheter on door-to-balloon time in primary transradial coronary intervention for ST segment elevation myocardial infarction.
abstract: The purpose of this study is to determine reduction of door-to-balloon (D2B) time using a single universal guiding catheter (Ikari-Left catheter) in transradial approach. In this procedure, we can skip a total of five steps compared with a conventional procedure (two catheter insertions, two catheter removals, and one catheter engagement). Reducing total ischemic time is important to achieving a better outcome in primary percutaneous coronary intervention (PCI) for ST segment elevation myocardial infarction (STEMI). We retrospectively compared 30 consecutive STEMI patients who underwent transradial primary PCI with a single guiding catheter (IL group) with 30 consecutive patients with conventional transradial primary PCI. Patients with cardiogenic shock, heart failure, or need for intra-aortic balloon pumping support before primary PCI were excluded. Baseline characteristics were not different between the two groups. The D2B time was significantly shorter in the IL group (55 ± 16 vs. 63 ± 17 min, respectively; p = 0.01). Puncture-to-balloon time was also significantly shorter in the IL group (15 ± 11 min vs. 25 ± 11 min, respectively; p = 0.001). The total number of diagnostic and guiding catheters was significantly less in IL group (1 (IQR 1-1) vs. 3 (IQR 3-3), respectively; p < 0.0001). Primary PCI with a single universal guiding catheter reduced D2B time by skipping several procedural steps, and reduced the total number of catheters needed. This technique could reduce patient mortality as well as total medical cost.
authors.affiliation: Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, 259-1193, Kanagawa, Japan.
authors.forename: Sho
authors.initials: S
authors.lastname: Torii
authors.affiliation: Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, 259-1193, Kanagawa, Japan.
authors.forename: Toshiharu
authors.initials: T
authors.lastname: Fujii
authors.affiliation: Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, 259-1193, Kanagawa, Japan.
authors.forename: Tsutomu
authors.initials: T
authors.lastname: Murakami
authors.affiliation: Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, 259-1193, Kanagawa, Japan.
authors.forename: Gaku
authors.initials: G
authors.lastname: Nakazawa
authors.affiliation: Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, 259-1193, Kanagawa, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Ijichi
authors.affiliation: Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, 259-1193, Kanagawa, Japan.
authors.forename: Masataka
authors.initials: M
authors.lastname: Nakano
authors.affiliation: Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, 259-1193, Kanagawa, Japan.
authors.forename: Yohei
authors.initials: Y
authors.lastname: Ohno
authors.affiliation: Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, 259-1193, Kanagawa, Japan.
authors.forename: Norihiko
authors.initials: N
authors.lastname: Shinozaki
authors.affiliation: Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, 259-1193, Kanagawa, Japan.
authors.forename: Fuminobu
authors.initials: F
authors.lastname: Yoshimachi
authors.affiliation: Department of Cardiology, Tokai University School of Medicine, 143 Shimokasuya, Isehara, 259-1193, Kanagawa, Japan. ikari@is.icc.u-tokai.ac.jp.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Ikari
mesh_terms: D000368:Aged; D057785:Catheters / Q000592:standards*; D017023:Coronary Angiography; D004562:Electrocardiography; D004867:Equipment Design; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D062645:Percutaneous Coronary Intervention / Q000379:methods*; D017534:Radial Artery; D012189:Retrospective Studies; D000072657:ST Elevation Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D015996:Survival Rate / Q000639:trends; D013997:Time Factors; D061665:Time-to-Treatment / Q000639:trends*; D016896:Treatment Outcome
keywords: Door-to-balloon time; IL; Ikari catheter; Primary PCI; STEMI; Transradial intervention