Abstract
Background
The most common cause of procedural failure in cardiac catheterization using the transradial approach is radial artery spasm. The aim of this study was to compare the procedural success rate of the 6‑Fr Glidesheath Slender with the 6‑Fr standard sheath in transradial coronary angiography and intervention.
Methods
Patients who underwent percutaneous coronary angiography via the transradial approach through placement of a 6-Fr Glidesheath Slender or a 6-Fr standard sheath for primary radial access were prospectively enrolled in the study.
Results
The study included 200 cases: 76 patients undergoing percutaneous coronary angiography with the Glidesheath Slender and 124 patients with the standard sheath. Failed procedures were recorded for 19 patients (9.5%), defined as inability to complete the procedure via the primary access. There was no difference in the percentage of failed cases between the Glidesheath Slender and standard sheath groups (10.5% vs. 8.9%, OR = 1.21, p = 0.8). More cases of spasm were observed in the Glidesheath Slender group compared with the standard sheath group, which was not statistically significant (7.9% vs. 5.7%, OR = 1.43, p = 0.56). Smoking, hyperlipidemia, and age influenced the procedural outcome in the Glidesheath Slender group, while body mass index, sex, and smoking impacted the procedural outcome in the standard sheath group.
Conclusion
There is no difference in procedural success rates, as defined by the ability to complete the procedure via primary radial access, between the 6‑Fr Glidesheath Slender and the 6‑Fr standard sheath. Our study suggests that the patient characteristics that elevate the risk of procedural failure for Glidesheath Slender may differ from those for the standard sheath.
Zusammenfassung
Hintergrund
Die häufigste Ursache des prozeduralen Versagens bei der Herzkatheterisierung unter Verwendung des transradialen Zugangswegs ist ein Spasmus der A. radialis. Ziel der vorliegenden Studie war es, die prozedurale Erfolgsrate der 6‑Fr-Glidesheath-Slender-Schleuse mit der 6‑Fr-Standardschleuse bei der transradialen Koronarangiographie und -intervention zu vergleichen.
Methoden
In die Studie wurden prospektiv Patienten aufgenommen, bei denen eine perkutane Koronarangiographie über den transradialen Zugangsweg unter Platzierung einer 6‑Fr-Glidesheath-Slender-Schleuse oder einer 6‑Fr-Standardschleuse für den primären Zugang zur A. radialis durchgeführt wurde.
Ergebnisse
Die Studie umfasste 200 Fälle: 76 Patienten mit perkutaner Koronarangiographie unter Einsatz der Glidesheath-Slender-Schleuse und 124 Patienten mit Standardschleuse. Ein misslungener Eingriff wurde bei 19 Patienten dokumentiert (9,5 %) und war definiert als Unmöglichkeit, den Eingriff über den primären Zugang bis zum Ende durchzuführen. Es bestand kein Unterschied beim Anteil misslungener Eingriffe zwischen der Glidesheath-Slender-Gruppe und der Gruppe mit Standardschleuse (10,5 vs. 8,9 %; Odds Ratio, OR = 1,21; p = 0,8). In der Glidesheath-Slender-Gruppe wurden mehr Fälle mit Spasmus beobachtet als in der Gruppe mit Standardschleuse, jedoch ohne statistische Signifikanz (7,9 vs. 5,7 %; OR = 1,43; p = 0,56). Rauchen, Hyperlipidämie und Alter beeinflussten das prozedurale Ergebnis in der Glidesheath-Slender-Gruppe, während Body-Mass-Index, Geschlecht und Rauchen einen Einfluss auf das prozedurale Ergebnis in der Gruppe mit Standardschleuse hatten.
Schlussfolgerung
Zwischen der Glidesheath-Slender-Schleuse und der Standardschleuse bestand kein Unterschied bei den Raten des prozeduralen Erfolgs, der definiert war als in der Lage zu sein, den Eingriff über den primären Zugang zur A. radialis bis zum Ende durchzuführen. Die vorliegende Studie liefert Hinweise darauf, dass die Patientenmerkmale, die das Risiko eines prozeduralen Versagens für die Glidesheath-Slender-Schleuse erhöhen, sich möglicherweise von denen für die Standardschleuse unterscheiden.
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B. Gul, M. Stolar, B. Stair, P. Hermany, S. Willis, C. Mena-Hurtado, and R. Attaran declare that they have no competing interests.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was obtained from all individual participants included in the study.
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Gul, B., Stolar, M., Stair, B. et al. Comparison of procedural success between two radial sheaths. Herz 45, 79–85 (2020). https://doi.org/10.1007/s00059-018-4707-1
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DOI: https://doi.org/10.1007/s00059-018-4707-1