Multicentre, prospective, randomized trial of 4 vs. 6 French catheters in 410 patients undergoing coronary angiography

Todd, Derick; Hübner, Peter; Hudson, Norah M.; Sarma, Jaydeep; McCance, A J; Caplin, John L.

doi:10.1002/ccd.1283

Cited by 12 publications

(15 citation statements)

References 14 publications

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“…The angiograms were analyzed separately by these three observers after simultaneous evaluation of ten initial to standardize the scoring system. The CAG was graded quantitatively on the quality for each artery as follows: 3, complete opacification of the entire length of the vessel throughout systole and diastole; 2, complete opacification of the vessel, but nonpersistent opacification throughout systole and diastole or moderate opacification of the vessel throughout systole and diastole; 1, moderate opacification of the vessel in systole or diastole only with acquisition of a diagnostic image; 0, nondiagnostic image [14]. Each artery was given a visual score for each standard view.…”

Section: Study End Points and Definitionsmentioning

confidence: 99%

Novel diagnostic catheter specifically designed for both coronary arteries via the right transradial approach

Kim

et al. 2005

Int J Cardiovasc Imaging

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The aim of this study was to assess the feasibility, safety, and performance of a novel diagnostic catheter specifically designed for engaging both coronary arteries via the right transradial artery approach. A total of 160 patients were randomized between the standard Judkins (5F R4, L4; Cordis Corporation, Miami, FL) and the 5F Tiger II (Terumo Corporation, Tokyo, Japan) catheters. End points included the duration of various procedures and the assessments of angiographic image quality and catheter performance. The Tiger II was associated with a significantly shorter (40%) total procedure time (199.6+/-50.2 vs. 331.5+/-72.9 s, p=0.001) and a 33% shorter total fluoroscopic time (93.1+/-33.8 vs. 138.2+/-47.6 s, p=0.001) for diagnostic coronary angiography, compared with those with the Judkins catheter. There was no significant difference between the Tiger II and Judkins catheters for left coronary angiographic quality (left anterior descending, 2.82+/-0.48 vs. 2.94+/-0.29, p=0.084; left circumflex, 2.90+/-0.38 vs. 2.87+/-0.44, p=0.629). The Tiger II provided superior right coronary angiograms, compared with the Judkins catheter (2.99+/- 0.11 vs. 2.82+/-0.48, p=0.003). For the left coronary angiograms, the initial randomized catheter completed the procedure in 91% of the patients with the Tiger II and in 98% with the Judkins (p=0.167) catheters. For the right coronary angiograms, 100% were completed with the Tiger II and 95% with the Judkins (p=0.120) catheters. There were no angiographic or clinical complications in either group, so the procedural success rate was 100%. The potential of the Tiger II catheter for use as a multipurpose catheter for right transradial coronary angiography to reduce procedural and X-ray times to the level of classic transfemoral coronary angiography has to be confirmed in a randomized study.

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Section: Study End Points and Definitionsmentioning

confidence: 99%

Novel diagnostic catheter specifically designed for both coronary arteries via the right transradial approach

Kim

et al. 2005

Int J Cardiovasc Imaging

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“…Qualitative analysis of the left ventriculograms and coronary angiograms utilizing a grading system was performed [11]. The left ventriculogram grading consisted of 0, image nondiagnostic; 1, poor opacification of left ventricular cavity; 2, partial identification of the left ventricular border throughout systole and diastole or complete identification of the border but not throughout systole and diastole; 3, borders of the left ventricular cavity clearly seen throughout systole and diastole.…”

Section: Angiographic Analysismentioning

confidence: 99%

Randomized comparison of rapid ambulation using radial, 4 French femoral access, or femoral access with AngioSeal closure

Reddy

Brewster

Walsh

et al. 2004

Cathet Cardio Intervent

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Radial access and closure devices are associated with improved quality of life (QOL) after cardiac catheterization. Whether this is related to the access site or time to ambulation is unknown. Seventy-five patients undergoing cardiac catheterization were randomized to femoral 6 Fr with AngioSeal closure (F+C), femoral 4 Fr without closure, and radial (R) access. All patients were ambulated at 1 hr. QOL was measured utilizing visual analogue scales and Short Form-36 at baseline, 1 day, and 1 week. Time to ambulation and discharge were equivalent, as was postprocedure QOL. However, angiographic quality was lower in the 4 Fr group (P < 0.0001) and catheterization costs were higher in the F+C group (P < 0.0001). Ambulation 1 hr after catheterization can be accomplished utilizing radial, femoral 6 Fr with closure device, or femoral 4 Fr access with equivalent outcomes and QOL. However, this is achieved at a higher cost with a closure device, or lesser angiographic quality with 4 Fr catheters.

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“…Todd et al . [13] in a similar study comparing hemodynamic examination using 4 Fr and 6 Fr catheters through femoral access did not observe any differences in procedure time or X-ray fluoroscopy time; however, they found greater use of contrast medium with the use of 4 Fr catheters. The patients were given verapamil and heparin routinely.…”

Section: Discussionmentioning

confidence: 91%

Evaluation of the usefulness of coronary catheters and 4 Fr insertion sets for transradial access coronarography in comparison with catheters and 5 Fr sets

Chodór¹,

Morawski²,

Sulik-Gajda³

et al. 2013

pwki

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IntroductionApplication of transradial arterial access during coronarography, besides pain, means faster patient mobilization and fewer complications. During those procedures, vascular sheaths and 5/6 Fr catheters, and lately 4 Fr catheters, are used.AimTo assess the usefulness of 4 Fr catheters and sheaths in comparison to 5 Fr in diagnostic coronarography.Material and methodsIn the period from 5.12.2010 to 27.02.2012, a group of patients who had coronarography with a 4 Fr catheter (n = 20) and a 5 Fr catheter (n = 20) were studied. Technical issues and potential problems related to the use of each catheter were analyzed. Morphology, biochemical parameters, and local complications were analyzed. The assessment included pain intensification during catheter removal and insertion in the VAS/numerical (0–10)/verbal scales and the quality of image obtained during the coronarography.ResultsAll the angiograms obtained during all the interventions were of diagnostic value and in invasive cardiologists’ opinions, they did not differ statistically in clarity. Moreover, there were no statistically significant differences in radiation/fluoroscopy time, amount of contrast medium, or morphological and biochemical parameters. The size of hematomas in the 4 Fr group was 17.55 ±14.6 cm2, and in the 5 Fr group 31.07 ±32.11 cm2, p = 0.12. The average intensity of pain felt during the intervention/at the time of its removal and insertion in the numerical scale was in the 4 Fr group 0.65 ±0.93/0.55 ±0.94 and in the 5 Fr group 1.88 ±1.64/1.42 ±1.61, p < 0.05.ConclusionsApplication of 4 Fr catheters allows one to perform a diagnostic procedure with a small number of local and hemorrhagic complications comparable with 5 Fr catheters. Due to reduced pain, it is appropriate to continue studies with the use of 4 Fr catheters and sheaths.

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Multicentre, prospective, randomized trial of 4 vs. 6 French catheters in 410 patients undergoing coronary angiography

Cited by 12 publications

References 14 publications

Novel diagnostic catheter specifically designed for both coronary arteries via the right transradial approach

Novel diagnostic catheter specifically designed for both coronary arteries via the right transradial approach

Randomized comparison of rapid ambulation using radial, 4 French femoral access, or femoral access with AngioSeal closure

Evaluation of the usefulness of coronary catheters and 4 Fr insertion sets for transradial access coronarography in comparison with catheters and 5 Fr sets

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