Comparison of 4-French versus 5-French sheaths for diagnostic coronary angiography via the snuffbox approach
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Key result
Diagnostic coronary angiography via the snuffbox approach using a 4-French sheath resulted in a significantly shorter median hemostasis duration compared to a 5-French sheath (70 vs. 120 minutes, p<0.001).
Why the study?
The optimal duration of hemostasis in diagnostic CAG via the distal radial approach, termed the snuffbox approach, had not been well investigated.
Does a 4-Fr sheath reduce hemostasis duration compared to a 5-Fr sheath in patients undergoing diagnostic coronary angiography via the snuffbox approach?
Population
171 patients with suspected myocardial ischemia undergoing diagnostic CAG via the snuffbox approach
Comparison
4-Fr vs 5-Fr sheaths
Design
Single-center retrospective study
Follow-up
During hospitalization
Authors
Discussion
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Member takes
Implication
May shorten hemostasis time in snuffbox access; hypothesis-generating and requires randomized confirmation before practice change.
Study Design
Type
Observational (n=171)
Multicenter
No
Structured PICO
Does a 4-Fr sheath reduce hemostasis duration compared to a 5-Fr sheath in patients undergoing diagnostic coronary angiography via the snuffbox approach?
P
Population
171 patients with suspected myocardial ischemia undergoing diagnostic coronary angiography via the snuffbox approach at a single center, evaluated during hospitalization.
E
Exposure
4-French (Fr) radial sheath for diagnostic coronary angiography via the snuffbox approach
C
Comparator
5-French (Fr) radial sheath for diagnostic coronary angiography via the snuffbox approach
O
Outcome
Hemostasis durationsurrogate
Main Result
Absolute Event Rate: 70% vs 120%
p-value: p=<0.001
Diagnostic coronary angiography via the snuffbox approach using a 4-Fr sheath significantly reduces hemostasis duration compared to a 5-Fr sheath, with successful hemostasis achieved within 2 hours and no radial artery occlusions.
Limitations
- Retrospective study design with a small sample size
- Hemostasis duration after the snuffbox approach was evaluated without a conventional radial approach control group
- Occurrence of radial artery occlusion was evaluated only by manual pulse, without vascular ultrasonography
- Patency of both radial arteries was not evaluated after discharge
- Retrospective study with small sample size
- Hemostasis duration after the snuffbox approach was evaluated without a control group
Cite This Study
Roh et al. (2020) conducted an observational in Suspected myocardial ischemia (n=171). 4-French sheath vs. 5-French sheath was evaluated on Median hemostasis duration (minutes) (p=<0.001). Diagnostic coronary angiography via the snuffbox approach using a 4-French sheath resulted in a significantly shorter median hemostasis duration compared to a 5-French sheath (70 vs. 120 minutes, p<0.001).
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