Aims
Transradial coronary intervention is usually performed via a 5- or 6-F sheath due to the small caliber of radial arteries. Various different angiographic techniques that require a guiding catheter of 7 F or larger could be impeded by radial approach because of the small size of the guiding catheter. Sheathless guiding catheters are newly developed devices composed of a hydrophilic catheter and a dilator. This combination of catheter and dilator enables us to introduce the catheter into the artery without the need of an introducer sheath. Because the outer diameter of sheathless guiding catheter system is smaller than a conventional guiding catheter system, this system provides us with less invasive angioplasty and a puncture site injury. Our aim was to demonstrate the potential of this sheathless guiding system in a series of patients of 12 different hospitals from Spain.
Methods and results
All patients undergoing a percutaneous coronary intervention with a sheathless catheter system were included in the registry among 12 different Hospitals from Spain. Basal characteristics and angiographic features were reported. We also evaluated subjective perception of operators as well as complaints and suggestions related to the device. A total of 303 procedures were reported. Mean age of the population was 66 years; 74% were male. Right and left radial access was used in 92.5% and 7.5% of cases, respectively. Conversion to femoral approach or radial approach with introducer was reported in 3.2% of cases. Extra backup-type catheters were used in 46% of cases, with the LAD being the most frequently approached artery (46%). Kissing and cutting balloon techniques were reported in 23.1% and 9.6% of cases, respectively, as well as complex techniques like crush and rotational atherectomy in 3.0% and 5.2% of cases, respectively. Procedural success rate was 94.3%. Operators’ subjective perception was “very good” in 34% and “good” in 59%. Most of the complaints received were related to the lack of backup force and the need to increase system tip radiopacity. Complications related to the device were low (wrist pain 1.3%, puncture site hematoma 3.6% and forearm hematoma 0.7%). Two aorto-ostial complications were reported.
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