Safety and feasibility of the new 5 Fr Glidesheath Slender
Tóm tắt
The aim of this study was to evaluate the safety and feasibility of the new 5 Fr Glidesheath Slender (GSS). The transradial (TR) approach has become popular because of several advantages, such as a reduced rate of vascular access site complications. However, because the radial artery is narrow, a limitation of TR access is the potential for artery spasm or occlusion. Studies of radial artery size demonstrate that 5 Fr sheaths are too wide for more than 10 % of patients. The GSS (Terumo, Tokyo, Japan) is a new radial sheath with a thinner wall and a hydrophilic coating. It has an inner diameter that is compatible with a 5 Fr guiding catheter, while the outer diameter is similar to that of a 4 Fr sheath. A total of 21 consecutive patients undergoing transradial angiography and/or transradial percutaneous coronary intervention with the 5 Fr GSS were included, and safety and feasibility of the device were assessed. Transradial angiography was performed in 10 patients, and transradial intervention in 11 patients. All procedures were successful, without the need for conversion to the transfemoral approach. The radial artery occlusion rate was 0 %, including a patient who had experienced six previous radial artery punctures. There were no cases of artery spasm, hematoma, major bleeding or functional disorders. One coronary artery perforation caused by a guidewire was reported, but it was unrelated to the sheath introducer. The new 5 Fr GSS was safe and feasible for transradial angiography and transradial intervention.
Tài liệu tham khảo
Feldman DN, Swaminathan RV, Kaltenbach LA, Baklanov DV, Kim LK, Wong SC, et al. Adoption of radial access and comparison of outcomes to femoral access in percutaneous coronary intervention: an updated report from the national cardiovascular data registry (2007–2012). Circulation. 2013;127:2295–306.
Jolly SS, Amlani S, Hamon M, Yusuf S, Mehta SR. Radial versus femoral access for coronary angiography or intervention and the impact on major bleeding and ischemic events: a systematic review and meta-analysis of randomized trials. Am Heart J. 2009;157:132–40.
Romagnoli E, Biondi-Zoccai G, Sciahbasi A, Politi L, Rigattieri S, Pendenza G, et al. Radial versus femoral randomized investigation in ST-segment elevation acute coronary syndrome: the RIFLE-STEACS (Radial versus femoral randomized investigation in ST-Elevation acute coronary syndrome) study. J Am Coll Cardiol. 2012;60:2481–9.
Fujii T, Masuda N, Toda E, Shima M, Tamiya S, Ito D, et al. Analysis of right radial artery for transradial catheterization by quantitative angiography–anatomical consideration of optimal radial puncture point. J Invasive Cardiol. 2010;22:372–6.
Saito S, Ikei H, Hosokawa G, Tanaka S. Influence of the ratio between radial artery inner diameter and sheath outer diameter on radial artery flow after transradial coronary intervention. Catheter Cardiovasc Interv. 1999;46:173–8.
Aminian A, Dolatabadi D, Lefebvre P, Zimmerman R, Brunner P, Michalakis G, et al. Initial experience with the Glidesheath Slender for transradial coronary angiography and intervention: a feasibility study with prospective radial ultrasound follow-up. Catheter Cardiovasc Interv. 2014;84:436–42.
Wewers ME, Lowe NK. A critical review of visual analogue scales in the measurement of clinical phenomena. Res Nurs Health. 1990;13:227–36.
Schulman S, Kearon C. Definition of major bleeding in clinical investigations of antihemostatic medicinal products in non-surgical patients. J Thromb Haemost. 2005;3:692–4.
Gwon HC, Doh JH, Choi JH, Lee SH, Hong KP, Park JE, et al. A 5Fr catheter approach reduces patient discomfort during transradial coronary intervention compared with a 6Fr approach: a prospective randomized study. J Interv Cardiol. 2006;19:141–7.
Yoshimachi F, Masutani M, Matsukage T, Saito S, Ikari Y. Kissing balloon technique within a 5 Fr guiding catheter using 0.010 inch guidewires and 0.010 inch guidewire-compatible balloons. J Invasive Cardiol. 2007;19:519–24.
Matsukage T, Masutani M, Yoshimachi F, Takahashi A, Katsuki T, Saito S, et al. A prospective multicenter registry of 0.010-inch guidewire and compatible system for chronic total occlusion: the PIKACHU registry. Catheter Cardiovasc Interv. 2010;75:1006–12.
Kiemeneij F, Yoshimachi F, Matsukage T, Amoroso G, Fraser D, Claessen BE, et al. Focus on maximal miniaturisation of transradial coronary access materials and techniques by the Slender Club Japan and Europe: an overview and classification. EuroIntervention. 2015;10:1178–86.