Author + information
- Kazunori Horie,
- Norio Tada,
- Tsuyoshi Isawa,
- Takashi Matsumoto,
- Taku Honda,
- Tatsushi Otomo and
- Naoto Inoue
Background: Transradial coronary intervention (TRI) had reduced vascular complications compared with transfemoral approach, however there is concern of occlusion or spasm in radial arteries. Both 6.5-Fr sheathless hydrophilic-coating guide catheter™ (SH-GC) and 6.0-Fr Glidesheath Slender™ (GSS) were developed as less invasive system for TRI. However a comparative investigation has not been reported.
Methods: This trial is an open-label randomized study to compare the frequency of complications in radial arteries between patients received TRI using 6.5-Fr SH-GC vs. 6.0-Fr GSS. The primary endpoints were radial artery occlusion (RAO) evaluated by ultrasound 1 month after TRI, symptomatic radial artery spasm (RAS) and the procedure success. The secondary endpoints were the onset of major adverse cardiac events (MACE) and procedure times.
Results: From January 2015 to June 2016, we analysed consecutive 600 patients with stable coronary disease who underwent elective TRI using 6.5-Fr SH-GC (SH-GC group, n=300) or 6.0-Fr GSS (GSS group, n=300) in our hospital. Baseline patient and lesion characteristics were similar in both groups. However, the ratio of sheath/artery diameter (S/RA ratio) was significantly smaller in the SH-GC group (1.02 ± 0.23 vs. 1.17 ± 0.27, p<0.001), because the external diameter of 6.5-Fr SH-GC (2.16 mm) is smaller than one of 6.0-Fr GSS (2.46 mm). The procedural success rate (97.3% vs. 99.0%, p=0.121) and the rate of crossover to the other systems (1.7% vs. 0.7%, p=0.246) tended to be higher in SH-GC group respectively, however they were not statistically significant. The incidence rates of MACE (1.3% vs. 1.3%, p=1.000) and procedure times (46.6 ± 20.8 vs. 44.9 ± 20.1 minutes, p=0.322) were similar in both groups. The 6.5-Fr SH-GC was associated with significant reduction of RAO (0.0% vs. 1.7%, p=0.008) and RAS (0.3% vs. 2.0%, p=0.045), compared with the 6.0-Fr GSS. In multivariate analysis, the independent predictors of a composite of RAO and RAS were high S/RA ratio (p=0.008) and previous coronary artery bypass graft (p=0.037).
Conclusions: TRI using 6.5-Fr SH-GC can reduce post-procedural RAO and symptomatic RAS with equivalent procedural success, compared with 6.0-Fr GSS.
Poster Hall, Hall C
Sunday, March 19, 2017, 9:45 a.m.-10:30 a.m.
Session Title: Coronary Intervention in Interventional Cardiology: Core Concepts
Abstract Category: 21. Interventional Cardiology: Coronary Intervention: Devices
Presentation Number: 1286-177
- 2017 American College of Cardiology Foundation