Percutaneous coronary interventions using a new 5 French guiding catheter: Results of a prospective study

Abstract

The aim of this prospective study was to analyze the technical feasibility, the success rate, and the special complications of percutaneous coronary interventions (PCIs) using a newly released 5 Fr guiding catheter with an inner diameter of 0.058". The study was performed in 150 consecutive patients subjected to coronary angioplasty. In 89% of the patients, the intervention was started with a 5 Fr catheter (JR4 or JL4); in 16 patients a 6 or 7 Fr catheter was used because of unstable clinical conditions according to the decision of the interventional cardiologist. In 12 out of 134 patients, the guiding catheter had to be changed during the intervention from 5 Fr to a 6 or 7 Fr catheter due to poor backup support. In 112 out of 118 patients, the intervention was successfully performed using a 5 Fr catheter (95%); in 12 out of 16 patients, after changing the guiding catheter, the overall success rate was 93%. In patients with type A and B lesions who were initially treated using a 5 Fr catheter, the procedural success rate was 100% (81 out of 81), whereas in patients with type C lesions the procedural success rate was 83% (43 out of 53; P = 0.000053, Fisher's exact test). Furthermore, in patients with a diameter stenosis < 90%, the procedural success rate was 100% (57 out of 57), whereas in patients with a diameter stenosis of 90%-100%, the procedural success rate was 87% (67 out of 77; P = 0.0050). Stent implantation was performed successfully in 24 patients (18%) using the 5 Fr guiding catheter. This study confirms that PCI was technically feasible using a 5 Fr guiding catheter in the majority of consecutive patients with a success rate of 95%. There were significant differences in the success rate depending on the lesion type and the diameter stenosis. Complications were very rare and were not related to the guiding catheter. Limitations of the 5 Fr guiding catheters arose mainly from a poor backup support in long lesions and severe stenosis. Cathet Cardiovasc Intervent 2001;53:308-312.

Reinforcing effect of silica on the properties of styrene butadiene rubber–reclaim rubber blend system

“…The performance of 4‐Fr PCI, for example, required a certain learning curve [16]. In this study, however, the average procedure time, the average fluoroscopy time, and the contrast dye usage appeared comparable to those of previous reports using conventional 5‐Fr guiding catheters (36–45 min for procedure time, 10–16 min for fluoroscopy time, and 145–274 mL for contrast dye volume, respectively) [17–19]. Such comparable outcomes suggest that catheter manipulation of the virtual 3‐Fr system is not inferior to that of a regular 5‐Fr guiding catheter.…”

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

“…Furthermore, there was no comparative arm using a conventional sheath and GC system. Previous studies have confirmed that PCI using a conventional 5‐Fr sheath and GC system was technically feasible . Before the introduction of the Works system (5‐Fr sheathless GC) in our institution, PCI using conventional a 5‐Fr sheath and GC system was performed in 146 patients (160 lesions) from January 2008 to June 2010, and the clinical, angiographic, or procedural characteristics were similar to those in this study because the same operators performed PCI and chose the size of the GC (5‐Fr).…”

A randomized trial of 5 vs. 6 French transradial percutaneous coronary interventions

“…These restrictions have been reported to represent the predominant reason for radial spasms and postprocedural radial occlusions, especially if the radial diameter:sheath ratio is Ͻ 1.0 [2]. It is particularly among these patients that 5 Fr guiding catheter could help to improve procedural success rates and possibly reduce procedural failures and vascular access complications such as radial occlusions and hematomas, but 5 Fr, 0.058Љ lumen diameter guiding catheter affords less strength, visibility, and backup compared to 6 Fr [3]. Hence, we conducted a randomized study of 5 vs. 6 Fr transradial coronary interventions (TCI) in lesions not eligible to other than balloon angioplasty or stent implantation to ascertain whether 5 Fr has equivalent procedural success and complications rates as 6 Fr guiding catheter.…”