Coronary balloon angioplasty through diagnostic 6 french catheters

Abstract

We investigated the use of ultralow profile balloon catheters (Scimed ACE, USCI Probe, Cordis, Orion) for coronary angioplasty through 6 French diagnostic catheters (Schneider, Cordis). Contrast injection was assisted with a Hercules pump (Cordis) in all cases. During 21 procedures, angioplasty of 27 lesions in 20 selected patients was attempted (1.3 lesion/procedure). Twelve lesions were in the right, 10 in the left anterior descending, and 5 in the left circumflex coronary artery. Balloon size varied between 2.5 and 3.5 mm. Twenty lesions could be successfully dilated (74%) through the 6 French catheter and 7 lesions required an exchange to a 7 French angioplasty guiding catheter. For 5 cases, another balloon was also necessary to complete the procedure. The final overall success rate was 100% per patient and per lesion and there were no major complications. Despite the small internal catheter lumen (1.22 mm) coronary visualization was adequate, and mechanical support was good. Failures of 6 French catheters were attributed to insufficient torque control and excessive friction when the balloon crossed the tapered end of the diagnostic catheter. Coronary angioplasty through a diagnostic 6 French catheter is feasible and may represent a reasonable alternative for simple cases that are done during the same session as the diagnostic angiography. Once available, 6 French high flow angioplasty guiding catheters without a tapered tip should improve success while retaining the advantage of a small femoral puncture site.

Sheath pulling immediately after PTCA: Comparison of two different deployment techniques for the hemostatic puncture closure device: A prospective, randomized study

“…Noncompliance of the patient regarding strict bedrest after the procedure (at a 30 degree angle for 8 hr) has been reported to be a substantial factor for femoral complications after PTCA, increasing the risk of hematoma formation by a factor of 14 and the risk of rebleeding by a factor of 2.5 [12,16]. Reducing the sheath size and/or the revival of the transradial approach was presumed to result in fewer vascular complications and increased patient comfort after PTCA [17][18][19][20][21][22][23][24][25]; however, bleeding complications were not related to the sheath sizes [13,26,27].…”

Bleeding complications in patients with acute coronary syndrome undergoing early invasive management can be reduced with radial access, smaller sheath sizes, and timely sheath removal

“…However, advances in equipment, including reductions in device and catheter caliber, have allowed for coronary angioplasty procedures to be performed through 4-6 Fr catheters and sheaths [37][38][39][40]. Several retrospective studies have identified associations between sheath size and access site complications [5,7,8], although other studies have not found any association [6,10].…”

Percutaneous transluminal coronary angioplasty through 4 french diagnostic catheters

“…Even the atrial repolarization (small arrow) can be discerned in the lntracoronary lead. withdrawal through the first generation of 6F catheters used for PTCA [3]. With the new generation ACE balloons featuring a slippery coating, retrieving the balloon through 6F catheters with a lumen of 0.050 inch or larger has been possible in 90% of cases with balloon sizes up to 4.0 mm.…”