A Randomized Trial of 5 versus 7 French Guiding Catheters for Transfemoral Percutaneous Coronary Stent Implantation

Abstract

Comparative studies between 5 French guiding catheter and others of larger size using the transfemoral approach to coronary stenting have not been described. Coronary stent implantation was performed in 90 patients in a randomized trial. The primary end-point was to compare the incidence of successful uncomplicated stent implantation per lesion with the 5F and 7F guiding catheters. Patients were excluded for excessive vessel tortuosity or anticipated need for equipment not fitting through a 5 catheter. Baseline characteristics and the use of direct stenting did not differ between the two groups. The primary success rate was 97.8% per patient in both groups and 98% per lesion in the 5 French and 97.9% in the 7 French. Guiding catheter change was necessary in 1 patient in each group to successfully complete the procedure in both groups. The amount of contrast used was 63 +/- 27.3 mL in the 5 French and 76 +/- 25 mL in the 7 French groups (P < 0.05). Vascular complications and blood transfusions occurred somewhat more frequently in the 7 French group (P = 0.058). The manual compression time after sheath removal was 5.1 +/- 2.0 min and 8.0 +/- 4.3 min, respectively, in the 5 and 7 French groups (P < 0.01). In conclusion, the 5 French guiding catheters showed a similar success rate with coronary stenting when compared to the 7 French, but the amount of contrast used and manual compression time after sheath removal, as well as the rate of vascular and bleeding complications, were reduced in the 5 French group.

Transradial versus Transfemoral Approach in Patients Undergoing Percutaneous Coronary Intervention for Acute Coronary Syndrome. A Meta-Analysis and Trial Sequential Analysis of Randomized Controlled Trials

“…In fact, in the Leipzig registry [42], radial artery occlusion was documented with vascular ultrasound in 30.5% and 13.7% of patients treated with 6-F and 5-F sheaths, respectively. Similar results may be achieved through 5-F TFA [43].…”

The CIAO (Coronary Interventions Antiplatelet-based Only) Study

“…Bleeding events were consistently lower in the group of patients who did not receive systemic anticoagulation. Of note, all events were related to access site complication, and none of them resulted in a surgical procedure or required blood transfusion (17).…”

Arteriotomy closure device safety after percutaneous coronary intervention in the direct thrombin inhibitor era: A comparative study

“…Six and 7 French sheaths are primarily used at our institution, though there are some cases using 8 French, and a few cases utilizing 5 French sheaths. Smaller sheath sizes have been associated with a reduction in complication rates . Reasons for not choosing an ACD are not collected in our interventional database.…”