Author + information
- Mohammad Reza Movahed, MD, PhD⁎ ( )()
- ↵⁎The Southern Arizona VA Health Care System, University of Arizona School of Medicine, Department of Medicine, Division of Cardiology, 1501 North Campbell Avenue, Tucson, Arizona 85724
With great interest, I read the paper by Rathore et al. (1). In this study, the investigators exclusively used Cook Medical (Bloomington, Indiana) hydrophilic-coated sheaths. They found significantly higher rate of abscess formation and infection in patients randomized to hydrophilic-coated Cook sheaths. This reaction has been described in the literature by many investigators (2–6) and has been exclusively related to the use of coated Cook sheaths but not other coated sheaths. Many centers with similar experience changed their practice by using other coated sheaths eliminating this adverse event. Rathore et al. (1) downplayed this reaction and did not mention that this adverse event has exclusively been reported in association with hydrophilic-coated Cook sheaths. They should have mentioned this painful and costly adverse reaction in their abstract result and conclusion and advised against using hydrophilic-coated Cook sheaths. Making a general statement in their discussion that all coated sheaths may have this problem is misleading and incorrect. Terumo M Coat hydrophilic sheaths (Terumo Interventional Systems, Somerset, New Jersey) may be substituted for coated Cook sheaths as such an adverse event has not been reported with Terumo sheaths. Furthermore, Rathore et al. (1) downplayed the fact that they did not routinely use antispasm medications in their study limiting their results and conclusion. I cannot recall any centers in the U.S. that do not routinely use antispasm medications. It is not clear why the authors avoided routine use of antispasm medications in their patients. Routine use of antispasm medications could have markedly reduced their patient discomfort and the risk of radial artery occlusion.
- American College of Cardiology Foundation