Cardiovascular Department, Sakurakai Takahashi Hospital, Kobe, Hyogo, Japan.
Cardiovascular Department, Izumikawa Hospital, Minamishimabara, Nagasaki, Japan.
Cardiovasc Revasc Med. 2024 Apr;61:64-67. doi: 10.1016/j.carrev.2023.11.011. Epub 2023 Nov 18.
This study aimed to assess the efficacy and safety of a sheathless guiding system in patients who underwent percutaneous coronary intervention (PCI) with distal radial access (DRA).
Hyperion™ Sheathless® guiding catheter (Asahi Intecc, Japan), one of the latest 6-Fr guiding systems for transradial PCI characterized by novel outer dilator, is considered to facilitate smooth insertion of the catheter to the artery and may contribute to further reduction of access site complications in DRA.
Between October 2018 and January 2023, 286 patients underwent PCI with a Hyperion™ Sheathless® guiding catheter with DRA at two Japanese hospitals. Procedural success, bleeding complications, and radial artery occlusion (RAO) detected by Doppler ultrasonography were assessed.
Mean age of the patients was 72.7 years, and 236 patients (82.5 %) were male. The target lesions were located in the right coronary artery, left anterior descending artery, left circumflex artery, and left main trunk in 81, 44, 50 patients, and 18 patients respectively. Procedural success rate was 99.7 % with no patients requiring conversion to conventional radial access. Two patients presented with a forearm hematoma equivalent to an Early Discharge After Transradial Stenting of Coronary Arteries Study hematoma classification Grade II and 23 with Grade I. No patient presented minor or major bleeding according to the Thrombolysis in Myocardial Infarction bleeding classification. RAO at 30-day follow-up was observed in 6 out of 277 patients (2.2 %).
6-Fr sheathless guiding system for PCI via DRA is feasible and associated with a low incidence of access site complications.
本研究旨在评估 Hyperion™ Sheathless® 无鞘引导系统在经远端桡动脉入路（DRA）行经皮冠状动脉介入治疗（PCI）患者中的疗效和安全性。
Hyperion™ Sheathless® 无鞘引导导管（日本朝日英达科）是最新的 6Fr 经桡动脉 PCI 引导系统之一，其特点是新型外扩张器，据认为可便于导管顺利插入动脉，并可能有助于进一步减少 DRA 中的入路部位并发症。
2018 年 10 月至 2023 年 1 月，在日本的两家医院，286 例患者采用 Hyperion™ Sheathless® 无鞘引导导管行经桡动脉入路 PCI。评估了手术成功率、出血并发症和经多普勒超声检测到的桡动脉闭塞（RAO）。
患者平均年龄为 72.7 岁，236 例（82.5%）为男性。靶病变位于右冠状动脉、左前降支、左回旋支和左主干的患者分别为 81 例、44 例、50 例和 18 例。手术成功率为 99.7%，无患者需要转换为常规桡动脉入路。2 例患者出现相当于 Early Discharge After Transradial Stenting of Coronary Arteries Study 血肿分级 II 的前臂血肿，23 例患者出现 I 级血肿。根据 Thrombolysis in Myocardial Infarction 出血分级，无患者发生轻微或严重出血。277 例患者中有 6 例（2.2%）在 30 天随访时出现 RAO。
经 DRA 行 PCI 的 6Fr 无鞘引导系统是可行的，且与较低的入路部位并发症发生率相关。
