A 5Fr Catheter Approach Reduces Patient Discomfort during Transradial Coronary Intervention Compared with a 6Fr Approach: A Prospective Randomized Study

Abstract

Smaller guiding catheters can help reduce local complications and patient morbidity during transradial coronary intervention (TRI). This study was designed to compare the patient's morbidity, success rate, and the operator's convenience between 5-French (5Fr) and 6-French (6Fr) TRIs. This is a single-center prospective randomized study. Patients who underwent TRI, in 2003, were prospectively randomized to either 5Fr or 6Fr catheter groups (100 patients in each group). Procedure-related patient morbidity as well as clinical and procedural characteristics was scored and analyzed. Procedural success rate was not significantly different between the groups. The number of unsatisfactory supports (6% in 5Fr group, 3% in 6Fr group; P=0.31) and the incidence of local wound complications were not significantly different between the groups. Local wound pain scores were significantly lower in the 5Fr group compared with the 6Fr group, particularly during sheath insertion and removal, and during procedures. Pain scores were higher in female patients than in male patients during sheath removal (male: 1.3+/-1.3, female: 1.7+/-1.5; P=0.049). Radial artery diameter was well correlated with local pain score during sheath removal (r=0.31, P<0.001), and with the height and weight of the patients (height: r=0.33, P<0.001; weight: r=0.27, P<0.001). In conclusion, using a 5Fr catheter during TRI reduce, local access site pain, particularly in female patients with smaller body size, whereas the success and local complication rates were similar to a 6Fr approach.

New Access for Radiofrequency Catheter Ablation of Left-Sided Atrioventricular Accessory Pathways Safety and Efficacy of the Transradial Approach

“…As the whole procedure was finished inside the sheath and did not stimulate the radial artery directly, the approach was convenient for extending the catheters to the left ventricle for mapping the mitral annulus and for determining the ablation sites, without incurring radial artery spasm in any patient, indicating this method is a safe alternative approach for ablation. As Gwon et al pointed out, 20 PCI via the radial artery using a 5Fr catheter can reduce patient discomfort during the procedure because of the smaller diameter of the catheter, and the results of the present study also support this advantage in RFCA.…”

Feasibility and Safety of Transradial Stenting for Unprotected Left Main Coronary Artery Stenoses

“…10,19 In addition, compliance and the ability of the radial artery to distend are reduced in patients with risk factors such as atherosclerosis, and endothelial dysfunction of radial artery is believed to correspond with the severity of CAD. 20,21 Nevertheless, a recent Korean study reported that the mean diameter of the radial artery was 2.60± 0.41 mm and one Japanese study further revealed that the reduction of radial artery flow after transradial PCI was less likely if the ratio of radial artery diameter to sheath outer diameter was ≥1.0.…”

Radial Artery Patency After Transradial Catheterization

“…12,38 It is interesting to note that an S-A ratio Ͼ1 is associated with pain during sheath insertion and removal. 41 In a prospective, randomized trial designed to test the hypothesis that sheath-artery mismatch contributes to RAO, Dahm et al 42 assigned patients to receive transradial PCI by means of a 5F system or a 6F system. Procedural success was similar between the 2 groups, but there was less RAO in the 5F group (1.1% versus 5.9%, Pϭ0.05).…”

“…38,40,41 Associations between radial artery diameter and body height, body weight, and body surface area are weak (rϭ0.23-0.33). 38,40,41 Brachial artery diameter may correlate more closely with body size, whereas the relative size of the radial and ulnar arteries is less predictable. The radial artery is larger than the ulnar in 51% of patients.…”