Usefulness of the Transradial 8Fr Sheathless Guiding Catheter Approach in Directional Coronary Atherectomy

Niizeki, Takeshi; Iwayama, Tadateru; Kumagai, Yu; Tohara, Satoru; Tsuchikane, Etsuo

doi:10.1177/11795476221075497

Cited by 2 publications

(1 citation statement)

References 9 publications

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“…1,4,5,9 Conversely, the disadvantages of DCA include the need for the transfemoral approach in most cases with a 7-Fr or 8-Fr guiding catheter and precise intravascular ultrasound guidance, resulting in a longer procedural time and a higher contrast volume than standard PCI. 1 However, in recent years, two novel methods have been reported to perform DCA using the transradial approach, including the use of an 8-Fr sheathless guiding catheter 16 or a dual catheter system via the bilateral radial arteries. 17 As these methods become increasingly common, the number of transradial DCA procedures may increase in the future.…”

Section: Discussionmentioning

confidence: 99%

One‐year outcomes of patients undergoing percutaneous coronary intervention with the revived directional coronary atherectomy catheter: Insights from the J‐PCI OUTCOME registry

Numasawa,

Sawano,

Ishii

et al. 2023

Cathet Cardio Intervent

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ObjectivesWe sought to investigate the 1‐year outcomes, including all‐cause and cardiovascular mortality, major adverse cardiovascular events (MACEs), and major bleeding, of patients undergoing percutaneous coronary intervention (PCI) with or without the revived directional coronary atherectomy (DCA) catheter in a Japanese nationwide registry.BackgroundClinical data regarding the midterm outcomes of patients undergoing PCI with DCA are scarce in contemporary real‐world practice.MethodsWe analyzed the data of 74,764 patients who underwent PCI at 179 hospitals from January 2017 to December 2018. The baseline characteristics and 1‐year outcomes of patients with stable coronary artery disease or unstable angina who underwent PCI with or without DCA were assessed.ResultsOverall, 431 patients (0.6%) underwent PCI with DCA. Patients in the DCA group were younger and predominantly male, with fewer comorbidities than patients in the non‐DCA group. Stentless PCI with DCA following additional drug‐coated balloon (DCB) angioplasty was the dominant strategy in the DCA group (43.6%). One‐year outcomes, including all‐cause mortality (1.2% in the DCA group vs. 2.5% in the non‐DCA group, respectively, p = 0.075), cardiovascular death (0.9% vs. 1.0%, p = 0.69), MACEs (1.9% vs. 1.8%, p = 0.96), and nonfatal major bleeding requiring readmission (1.2% vs. 1.4%, p = 0.62), were comparable between the two groups. In the DCA group, 1‐year outcomes were comparable, regardless of whether the stent or DCB was used.ConclusionsOne‐year clinical outcomes after PCI with DCA in patients with stable coronary artery disease or unstable angina are acceptable, regardless of stent use.

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