Renal artery intervention using a virtual 4.5‐Fr guiding catheter

A 6.5‐Fr guiding catheter (Parent Plus 45, Medikit, Tokyo, Japan), composed of a hydrophilic sheathless guiding catheter and a dilator, has recently been developed for the treatment of renal artery stenosis. Because of its unique sheathless configuration, its outer diameter is comparable to that of a conventional 4.5‐Fr introducer sheath, with the inner diameter being close in size to a 6.5‐Fr guiding catheter. These features allow this sheathless system to be used as the sole guiding catheter while the arterial damage at the puncture site remains equivalent to that of a 4.5‐Fr introducer sheath. We thus call this novel sheathless guiding catheter a virtual 4.5‐Fr system. To demonstrate the potential of this virtual 4.5‐Fr system, we report a case of renal artery stenosis successfully treated via the transradial route. This virtual 4.5‐Fr system may become a viable alternative to conventional guiding catheters, and provide a favorable impact upon vascular access complications and patient morbidity. © 2012 Wiley Periodicals, Inc.