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Mini‐invasive strategy in acute coronary syndromes: Direct coronary stenting using 5 Fr guiding catheters and transradial approach
Author(s) -
Hamon Martial,
Sabatier Rémi,
Zhao Quanming,
Niculescu Rodica,
Valette Benoît,
Grollier Gilles
Publication year - 2002
Publication title -
catheterization and cardiovascular interventions
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.988
H-Index - 116
eISSN - 1522-726X
pISSN - 1522-1946
DOI - 10.1002/ccd.10105
Subject(s) - medicine , stent , acute coronary syndrome , myocardial infarction , unstable angina , cardiology , timi , catheter , coronary stenting , angioplasty , percutaneous coronary intervention , balloon , coronary stent , surgery , restenosis
The purpose of this study was to assess the feasibility and safety of direct coronary stenting in acute coronary syndromes using 5 Fr guiding catheters by transradial approach. A series of 119 patients with an acute coronary syndrome (unstable angina, n = 55; acute myocardial infarction, n = 45; recent acute myocardial infarction, n = 19) explored by transradial approach and eligible for direct stenting were included. A large proportion of patients (52%) was treated during the procedure by platelet IIb/IIIa receptor blockade. Only Medtronic 5 Fr guiding catheters were used in this study. Direct coronary stenting was attempted in all 119 highly selected patients. Failure of direct stenting was observed in only five cases (3.9%) and the stent successfully retrieved in each case in the 5 Fr guiding catheter. In these five cases, balloon predilation was performed and then the stent implanted successfully. Different stents were used: ACS stent (54%), AVE stent (33%), Velocity stent (10%), Nir stent (3%), with diameter ranging from 2.5 to 4 mm. In four cases, the dilation was finally performed using 6 Fr guiding catheters because the backup of the 5 Fr catheter was considered to be too low (3%). No vascular access site complications occurred in this series of patients. We conclude that direct coronary stenting using transradial approach and 5 Fr guiding catheters yields excellent procedural success rate. In the setting of acute coronary syndromes requiring platelet IIb/IIIa receptor blockade or after failure of thrombolysis, this mini‐invasive strategy is very attractive because of the low risk of access site complications. Cathet Cardiovasc Intervent 2002;55:340–343. © 2002 Wiley‐Liss, Inc.