Coronary stenting with 5 French guiding catheters achieved a similar success rate per lesion (98% vs 97.9%) compared to 7 French catheters, with reduced contrast use and manual compression time.
RCT (n=90)
Does a 5 French guiding catheter improve procedural outcomes compared to a 7 French guiding catheter in patients undergoing transfemoral percutaneous coronary stent implantation?
Using a 5 French guiding catheter for transfemoral coronary stenting yields similar success rates to a 7 French catheter but significantly reduces contrast volume and manual compression time.
Tasa de eventos absoluta: 98% vs 97.9%
Comparative studies between 5 French guiding catheter and others of larger size using the transfemoral approach to coronary stenting have not been described. Coronary stent implantation was performed in 90 patients in a randomized trial. The primary end-point was to compare the incidence of successful uncomplicated stent implantation per lesion with the 5F and 7F guiding catheters. Patients were excluded for excessive vessel tortuosity or anticipated need for equipment not fitting through a 5 catheter. Baseline characteristics and the use of direct stenting did not differ between the two groups. The primary success rate was 97.8% per patient in both groups and 98% per lesion in the 5 French and 97.9% in the 7 French. Guiding catheter change was necessary in 1 patient in each group to successfully complete the procedure in both groups. The amount of contrast used was 63 +/- 27.3 mL in the 5 French and 76 +/- 25 mL in the 7 French groups (P < 0.05). Vascular complications and blood transfusions occurred somewhat more frequently in the 7 French group (P = 0.058). The manual compression time after sheath removal was 5.1 +/- 2.0 min and 8.0 +/- 4.3 min, respectively, in the 5 and 7 French groups (P < 0.01). In conclusion, the 5 French guiding catheters showed a similar success rate with coronary stenting when compared to the 7 French, but the amount of contrast used and manual compression time after sheath removal, as well as the rate of vascular and bleeding complications, were reduced in the 5 French group.
Büchler et al. (Tue,) conducted a rct in Coronary stent implantation (n=90). 5 French guiding catheter vs. 7 French guiding catheter was evaluated on incidence of successful uncomplicated stent implantation per lesion. Coronary stenting with 5 French guiding catheters achieved a similar success rate per lesion (98% vs 97.9%) compared to 7 French catheters, with reduced contrast use and manual compression time.