Coronary angioplasty through 4 french diagnostic catheters

Abstract

In 50 consecutive patients subjected to coronary angioplasty immediately following a 4 French (F) diagnostic study, the technical feasibility and economical aspects of angioplasty through 4F catheters of 54 lesions were assessed. The patients were selected, but multiple, eccentric, and long lesions were not a priori excluded. 4F diagnostic catheters (Cordis), and fixed-wire dilatation catheters (Ace, Scimed) were used in all cases. The procedure was successful in 43 lesions (80%) using 4F catheters. For 11 stenoses (20%), a change over to a larger French size was required. Two of these lesions could not be crossed with the balloon despite the larger sized guiding catheter. The final overall success rate was 96%, and there were no major complications. The use of diagnostic 4F catheters for angioplasty in these 50 patients resulted in the saving of 39 guiding catheters and 19 introducer sheaths. For 12 lesions (22%), an additional 4F catheter became necessary since the shape used for the diagnostic study was inadequate for angioplasty. In 7 cases, more than 1 balloon was used, but 5 of these balloon exchanges were independent of the use of 4F catheters. Three exchanges were performed through the 4F catheter (1 for need of a larger balloon to improve on an unsatisfactory angiographic result and 2 for a crimped guide wire tip of the Ace balloon). In the remaining 4, a larger catheter was used; in 2 of them, angioplasty eventually failed (failure to cross lesion) and in the remaining 2, a Monorail system solved the problem, which is incompatible with 4F catheters.(ABSTRACT TRUNCATED AT 250 WORDS)

Comparison of 7 and 8 french guiding catheters for elective PTCA: Results of a prospective randomized trial

“…The theoretical advantages of smaller catheters include reduced local vascular complications, decreased coronary pressure damping, less blood loss during PTCA, and facilitation of early ambulation after the procedure [1][2][3][4][5][6][7][8]10,11]. The potential disadvantages include catheter softening, resulting in inadequate backup to cross tortuous, distal, or calcified lesions; inability to accommodate large devices, such as intracoronary stents, perfusion catheters, and atherectomy devices; and coronary artery dissection due to increased manipulation required to secure adequate backup.…”

Bleeding complications in patients with acute coronary syndrome undergoing early invasive management can be reduced with radial access, smaller sheath sizes, and timely sheath removal

“…However, advances in equipment, including reductions in device and catheter caliber, have allowed for coronary angioplasty procedures to be performed through 4-6 Fr catheters and sheaths [37][38][39][40]. Several retrospective studies have identified associations between sheath size and access site complications [5,7,8], although other studies have not found any association [6,10].…”

Six French sheathless coronary angioplasty using a novel technique to introduce the guiding catheter: The INTRUC, a preliminary retrospective study

“…This preference for 6F G-Cs is growing, as these advantages have been supported by preliminary studies and large registries which clearly demonstrate that the vascular complication rate is related to G-C Size [6][7][8]. In order to reduce these bleeding complications and permit earlier hospital discharge, it would be tempting to perform coronary angioplasty with smaller G-Cs, but this might result in deleterious outcomes, because of a lack of angiographic control and inability to use many bailout devices [9,10]. In order to diminish the size of the vascular puncture site while keeping the large and safe lumen of the 6 French G-C, we have developed a new device called the INTRUC, to introduce the 6F G-C percutaneously without need of an external sheath (INTRUC stands for Introducing-catheter).…”