AIMS: The transradial approach (TRA) reduces hospitalisation and access-site complications as compared to the transfemoral approach. Nevertheless, the TRA technical failure rate is significantly higher compared to the transfemoral approach. The high failure rate of TRA is due to a series of factors. In particular, a wide range of anatomic vascular variants hindering procedural success may be present in patients undergoing TRA procedures. METHODS AND RESULTS: In our retrospective observational study, 1,596 consecutive patients with upper limb vascular anomalies underwent TRA between January 2006 and July 2017. We evaluate the usefulness of the sheathless guiding catheter system (SG) as compared to the conventional guiding catheter (CG). The primary study endpoint was the "procedural success" defined as successful transradial procedure (both selective cannulation of the coronary ostium in the diagnostic procedure and successful stent delivery in the interventional procedure) without access change. All SG procedures were successful, whereas only 1,274 (86%) CG procedures were successfully performed (p=0.0001). At multivariable analysis, age (p=0.001) and sheathless catheter use (p=0.001) were independent predictors of procedural success. CONCLUSIONS: The sheathless GC is a safe and useful system not only for small radial access but also in the presence of upper vascular anomalies and it can be used in PCI and diagnostic procedures.
AIMS: The transradial approach (TRA) reduces hospitalisation and access-site complications as compared to the transfemoral approach. Nevertheless, the TRA technical failure rate is significantly higher compared to the transfemoral approach. The high failure rate of TRA is due to a series of factors. In particular, a wide range of anatomic vascular variants hindering procedural success may be present in patients undergoing TRA procedures. METHODS AND RESULTS: In our retrospective observational study, 1,596 consecutive patients with upper limb vascular anomalies underwent TRA between January 2006 and July 2017. We evaluate the usefulness of the sheathless guiding catheter system (SG) as compared to the conventional guiding catheter (CG). The primary study endpoint was the "procedural success" defined as successful transradial procedure (both selective cannulation of the coronary ostium in the diagnostic procedure and successful stent delivery in the interventional procedure) without access change. All SG procedures were successful, whereas only 1,274 (86%) CG procedures were successfully performed (p=0.0001). At multivariable analysis, age (p=0.001) and sheathless catheter use (p=0.001) were independent predictors of procedural success. CONCLUSIONS: The sheathless GC is a safe and useful system not only for small radial access but also in the presence of upper vascular anomalies and it can be used in PCI and diagnostic procedures.
Authors: Francesco Burzotta; Carlo Trani; Mario Attilio Mazzari; Antonella Tommasino; Giampaolo Niccoli; Italo Porto; Antonio Maria Leone; Giovanni Tinelli; Valentina Coluccia; Maria De Vita; Marta Brancati; Rocco Mongiardo; Giovanni Schiavoni; Filippo Crea Journal: Am Heart J Date: 2012-01-13 Impact factor: 4.749
Authors: D J Hildick-Smith; P F Ludman; M D Lowe; N G Stephens; A A Harcombe; J T Walsh; D L Stone; L M Shapiro; P M Schofield; M C Petch Journal: Am J Cardiol Date: 1998-03-15 Impact factor: 2.778
Authors: Sanjit S Jolly; Salim Yusuf; John Cairns; Kari Niemelä; Denis Xavier; Petr Widimsky; Andrzej Budaj; Matti Niemelä; Vicent Valentin; Basil S Lewis; Alvaro Avezum; Philippe Gabriel Steg; Sunil V Rao; Peggy Gao; Rizwan Afzal; Campbell D Joyner; Susan Chrolavicius; Shamir R Mehta Journal: Lancet Date: 2011-04-04 Impact factor: 79.321