Department of Cardiology, National Heart Center Singapore, Singapore.
EuroIntervention. 2011 Dec;7(8):930-5. doi: 10.4244/EIJV7I8A147.
To assess the safety and efficacy of a novel sheathless (SH) 6.5 Fr (French) hydrophilic-coated guiding catheter (GC) compared to the standard 5 Fr GCs in transradial coronary interventions (TRI).
Patients undergoing TRI with 6.5 Fr SH or 5 Fr GCs were included. Baseline characteristics and in-hospital outcomes were recorded. Primary endpoints were procedural success and presence of radial pulse at discharge. Secondary endpoints were successful GC support, in-hospital adverse events, access-site complications, procedural duration and contrast load. There were 269 patients with 146 procedures in each group. The SH GC group had more non-ST elevation MI, in-stent restenosis, high-risk and bifurcation lesions. Procedural success in both arms was 95.2%. One patient in each group (0.7%) experienced radial artery occlusion (RAO) after TRI, without clinical sequelae. One access-site haematoma and one minor stroke occurred in the 5 Fr group (none in the SH group, both p=ns). Mean procedure time (52±21 vs. 45±21 minutes, p=0.004) and contrast load (160±45 ml vs. 140±45 ml, p=0.003) were greater in the SH group.
Both 6.5 Fr SH GCs and 5 Fr GCs achieved high procedural TRI success with low RAO rates. The SH GC eliminated the disadvantages of the 5 Fr GC whilst maintaining the advantage of low RAO rates, and may become the GC of choice in TRI.
评估新型无鞘（SH）6.5Fr（法国）亲水涂层导引导管（GC）与标准 5Fr GC 在经桡动脉冠状动脉介入治疗（TRI）中的安全性和疗效。
纳入接受 6.5Fr SH 或 5Fr GC 行 TRI 的患者。记录基线特征和住院期间结局。主要终点为手术成功率和出院时桡动脉脉搏存在。次要终点为 GC 支持成功率、住院期间不良事件、入路部位并发症、手术持续时间和对比剂用量。每组各有 269 例患者，共 146 例手术。SH GC 组有更多的非 ST 段抬高型心肌梗死、支架内再狭窄、高危和分叉病变。两组手术成功率均为 95.2%。TRI 后每组各有 1 例（0.7%）患者发生桡动脉闭塞（RAO），但无临床后遗症。5Fr 组发生 1 例入路部位血肿和 1 例轻度卒中（SH 组均无，均 p=ns）。SH 组的平均手术时间（52±21 分钟 vs. 45±21 分钟，p=0.004）和对比剂用量（160±45 毫升 vs. 140±45 毫升，p=0.003）均大于 5Fr 组。
6.5Fr SH GC 和 5Fr GC 均能实现高成功率的 TRI，桡动脉闭塞率低。SH GC 消除了 5Fr GC 的缺点，同时保持了低桡动脉闭塞率的优势，可能成为 TRI 的首选 GC。
