Percutaneous coronary intervention using a novel 4‐French coronary accessor

BACKGROUND: Percutaneous coronary intervention (PCI) using a guiding catheter with small diameters may have a favorable impact on vascular access complications and patient morbidity. Here, we report the initial results of PCI using a 4-Fr coronary accessor. METHODS: A total of 31 patients underwent 4-Fr PCI. Exclusion criteria for 4-Fr PCI were (1) lesions associated with large side branches requiring wire protection or kissing balloon technique and (2) planned use of angioplasty devices which were not compatible with 4-Fr catheter. RESULTS: A total of 36 lesions, including 4 chronic total occlusions (CTO), were treated. Access sites included radial artery in 19 patients (61%), brachial artery in 8 (26%), and femoral artery in 4 (13%). Four-Fr PCI was successful in 34 of 36 lesions (94%) in 29 of 31 patients (94%). One of the two unsuccessful patients was a case of CTO, and the other a case of tortuous right coronary artery. In both, crossover to a 6-Fr PCI was necessary. Among successfully treated 34 lesions of the 29 patients, coronary stents were deployed in 30 lesions (88%). There were no stent dislodgements or inadequate contrast opacification. No access-site related complications including radial artery occlusion were observed. CONCLUSIONS: PCI with a 4-Fr coronary accessor is a viable alternative to the use of larger guide catheters. The advent of 4-Fr stent delivery system may afford a less invasive approach for the treatment of patients with coronary artery disease.