Safety and feasibility of 5 French Glidesheath Slender for complex transradial interventions in small diameter radial arteries

摘要

Transradial(TR) access has limitations in patients with small diameter radial arteries (SDRA) because of increased risk of radial artery(RA) spasm(RAS), access site crossover, procedure failure, and RA occlusion (RAO) despite adequate anticoagulation & patent hemostasis. A wide variation in RA diameter (RAD)have been reported in patients worldwide: from 2.4 to 3.2 mm (SE Asia); 1.8-1.9 mm (India);1.8-2.8 mm (North America). RAD is≤1.5 mm in 8-10% of our patients. The outer diameter of radial sheaths varies with manufacturers (≈2.4mm for 5F sheaths and 2.7 mm for 6Fr sheaths). The Glidesheath Slender (GSS~? Terumo, Japan) has a thinner wall, that reduces its outer diameter to 4Fr & has the potential to minimize RA: Sheath size mismatch, which is associated with higher risk of RAS and RAO especially in patients with SDRA. This non-randomized prospective study was performed on consecutive patients who presented to the Mission hospital Durgapur, India for coronary angiograms and/or angioplasty in July 2015 with the aim of assessing the safety and feasibility of the 5 Fr-GSS for complex coronary interventions in patients with SDRA using 5Fr guiding catheters.