Transradial coronary intervention using a novel 5-Fr sheathless guiding catheter.

We have recently developed a 5-Fr sheathless guiding catheter system (Virtual 3-Fr, Medikit, Japan), composed of a hydrophilic catheter and a central dilator. This combination of catheter and dilator enables us to introduce the catheter into the artery without the need of an introducer sheath. Because the outer diameter of this 5-Fr sheathless guiding catheter system is approximately 2-Fr sizes smaller than a conventional guiding catheter system, this system provides us with less invasive angioplasty and a puncture site injury equivalent to a conventional 3-Fr introducer sheath. To demonstrate the potential of this 5-Fr sheathless guiding system, we report two cases of chronic total occlusion successfully treated by the transradial approach. This novel 5-Fr sheathless system may become a viable alternative to conventional guiding catheters, and provide a favorable impact upon vascular access complications and patient morbidity. Copyright 2009 Wiley-Liss, Inc.