Feasibility and safety of a virtual 3-Fr sheathless-guiding system for percutaneous coronary intervention

Catheter Cardiovasc Interv. 2014 Sep 1;84(3):426-35. doi: 10.1002/ccd.25357. Epub 2014 Feb 4.

Abstract

Objectives: To evaluate the feasibility and safety of a virtual 3-Fr system [5-Fr sheathless-guiding catheter (GC)] for percutaneous coronary intervention (PCI).

Background: The use of miniaturized devices for PCI is gaining popularity because of increased patient comfort and decreased risk of access site complications.

Methods: From July 2010 to December 2012, consecutive patients who underwent elective PCI (planned or ad hoc PCI) at our hospital were enrolled. PCI using the virtual 3-Fr system was attempted as our initial strategy, unless a 6-Fr or larger GC was considered to be suitable [lesions with heavy calcification, large (>2 mm) side branches, or chronic total occlusion].

Results: Five hundred sixty-six patients underwent elective PCI during the study period, and 132 patients who met the criteria underwent PCI using the virtual 3-Fr system. Procedures using the virtual 3-Fr system were successful in 126 patients (95%); 111 (84%) were performed using the transradial approach, 110 (83%) were ad hoc procedures, and 45 (31%) were complex coronary lesions (type B2 or C). Six patients required conversion to a conventional 5- or 6-Fr sheath and catheter system. No intraoperative complications occurred, and radial artery patency was achieved in all patients who underwent transradial procedures.

Conclusions: PCI using the virtual 3-Fr system is a feasible and viable alternative to conventional procedures that use a sheath and GC in appropriately selected patients. This small-caliber system may minimize endovascular trauma, particularly during transradial coronary procedures.

Keywords: coronary artery disease; interventional devices; percutaneous coronary intervention.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Coronary Angiography
  • Coronary Artery Disease / diagnostic imaging
  • Coronary Artery Disease / surgery*
  • Equipment Design
  • Feasibility Studies
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Miniaturization
  • Percutaneous Coronary Intervention / instrumentation*
  • Radial Artery
  • Retrospective Studies
  • Treatment Outcome
  • User-Computer Interface*