Author + information
- Ahmed Amro,
- Obadah Aqtash,
- Hisham Hirzallah,
- Yazan Numan,
- Alaa Gabi,
- Emad AlKhankan,
- Majd Kanbour,
- Sutoidem Akpanudo and
- Mehiar EL-Hamdani
As in any vascular access, the size of guiding catheter is an operator preference. Although 5-Fr versus 6-Fr guiding catheters for transradial coronary intervention (TCI) have similar vascular safety profiles and can be performed safely and successfully with either, the data comparing the 5-Fr vs. 6-Fr guiding catheters for TCI in terms of fluoroscopy time, procedure time, and contrast amount in the setting of ACS is limited, and large RCTs are needed.
We conducted this study to compare the use of 5-Fr versus 6-Fr guiding catheters for TCI in the setting of ACS.
In this single-center retrospective cohort study, patients with ACS (STEMI, NSTEMI, and unstable angina) who underwent percutaneous coronary intervention using radial access (at least one stent) suing 5 Fr or 6 Fr guiding catheters in the period from July 2014 to July 2015 were included.
A total of 267 patients were included and divided into two groups; 5 Fr catheter group (203 patients) and 6 Fr catheter group (64 patients).
The primary endpoints were contrast amount, fluoroscopy time and procedure time.
The means for the primary outcomes were compared between the two groups (5 Fr vs. 6 Fr catheters) using Independent T score test.
There was a significant reduction in the volume of contrast medium used with the 5 Fr group compared to the 6 Fr group (130.66 +/- 3.46 ml vs. 166.25 +/- 10.05 ml in the 5 and 6 Fr groups, respectively; p < 0.001) as well as with fluoroscopy time (12.62 +/- 0.50 min vs. 16.61 +/- 1.28 min in the 5 and 6 Fr groups, respectively; p = 0.005). Also there was significant reduction in the procedure time in the 5 Fr group (38.74 +/- 1.27 min vs. 46.03 +/- 2.86 min in the 5 and 6 Fr groups, respectively; p = 0.023).
Percutaneous coronary intervention (PCI) using radial access in the setting of acute coronary syndrome (ACS) is safe and feasible, whether using 5 Fr or 6 Fr catheters. However using 5 Fr catheters for TCI could be preferred for patients presenting with ACS due to lower amount of contrast medium used and less fluoroscopy and procedure time.