Key result
Ikari Left guide catheter achieves 72-minute door-to-balloon time in STEMI PCI.
Why the study?
Optimizing care times from diagnosis to coronary reperfusion remains critical to reducing complications in patients with STEMI undergoing PCI.
Does a single 6-French Ikari Left guide catheter strategy reduce care times and complications compared to the usual Judkins catheter approach in STEMI patients undergoing PCI?
Observational (n=43)
No
Does a single 6-French Ikari Left guide catheter strategy reduce care times and complications compared to the usual Judkins catheter approach in STEMI patients undergoing PCI?
The use of a single 6-French Ikari Left guide catheter for both angiography and PCI in STEMI patients may reduce procedural times and complications compared to the traditional multi-catheter approach.
Short times support single-catheter feasibility in STEMI PCI; leaves open benefit versus Judkins in randomized trials.
Background Acute coronary syndrome (ACS) is the leading cause of morbidity and mortality worldwide. The different reperfusion strategies have evolved over the years, and efforts have been directed to reduce its complications. Among these strategies, the one that has shown the best results is percutaneous coronary intervention, which has significantly improved the survival and prognosis of these patients; however, this procedure is not free of complications since multiple factors are involved. Among them is the time of patient care from the time of diagnosis until the coronary reperfusion therapy is performed. Methodology In this study, we describe the experience in our center with the 6-French Ikari Left guide catheter as a strategy of radial angiography-angioplasty with a single catheter to reduce the care times of patients with acute ST-elevation myocardial infarction (STEMI) in our center and compare it with the series reported by other international centers since. To establish an alternative to the usual approach that consists of the use of Judkins catheters, diagnosis, and guiding. Results Our study showed a success rate for diagnostic angiography and percutaneous coronary intervention (PCI) with the 6- French Ikari Left catheter comparable to those obtained in other centers, even with lower complication rates than the usual approach with Judkins' Catheters. Conclusions The use of the 6-French Ikari Left catheter demonstrated shorter needle-device time and compared to other international series, it was shown to be shorter and related to shorter fluoroscopy time. Our study has a small sample and only included a highly selected population, which represents a limitation. This study is vulnerable to the different practices of the operators, with involvement in procedure time and use of contrast volume.
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Cervantes-Nieto et al. (2023) conducted an observational in ST-Segment Elevation Myocardial Infarction (STEMI) (n=43). 6-French Ikari Left guide catheter vs. Historical/international series was evaluated on Door-to-balloon time (D2B). The use of the 6-French Ikari Left guide catheter in patients with STEMI undergoing percutaneous coronary intervention achieved a mean door-to-balloon time of 72 minutes and a needle-to-device time of 17 minutes.
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