Abstract
The purpose of this study is to determine reduction of door-to-balloon (D2B) time using a single universal guiding catheter (Ikari-Left catheter) in transradial approach. In this procedure, we can skip a total of five steps compared with a conventional procedure (two catheter insertions, two catheter removals, and one catheter engagement). Reducing total ischemic time is important to achieving a better outcome in primary percutaneous coronary intervention (PCI) for ST segment elevation myocardial infarction (STEMI). We retrospectively compared 30 consecutive STEMI patients who underwent transradial primary PCI with a single guiding catheter (IL group) with 30 consecutive patients with conventional transradial primary PCI. Patients with cardiogenic shock, heart failure, or need for intra-aortic balloon pumping support before primary PCI were excluded. Baseline characteristics were not different between the two groups. The D2B time was significantly shorter in the IL group (55 ± 16 vs. 63 ± 17 min, respectively; p = 0.01). Puncture-to-balloon time was also significantly shorter in the IL group (15 ± 11 min vs. 25 ± 11 min, respectively; p = 0.001). The total number of diagnostic and guiding catheters was significantly less in IL group (1 (IQR 1-1) vs. 3 (IQR 3-3), respectively; p < 0.0001). Primary PCI with a single universal guiding catheter reduced D2B time by skipping several procedural steps, and reduced the total number of catheters needed. This technique could reduce patient mortality as well as total medical cost.
Highlights
Primary percutaneous coronary intervention (PCI) reduces the mortality rate in patients with acute ST segment elevation myocardial infarction (STEMI) [1, 2]
Reducing total ischemic time is important to achieving a better outcome in primary percutaneous coronary intervention (PCI) for ST segment elevation myocardial infarction (STEMI)
The D2B time was significantly shorter in the IL group (55 ± 16 vs. 63 ± 17 min, respectively; p = 0.01)
Summary
Primary percutaneous coronary intervention (PCI) reduces the mortality rate in patients with acute ST segment elevation myocardial infarction (STEMI) [1, 2]. Shorter doorto-balloon (D2B) time has strong association with a lower mortality rate [3,4,5]. Based on these data, a D2B time of \90 min has been established as a Class I recommendation in the current guidelines [6, 7]. A previous study showed that a high success rate was achieved safely in transradial PCI using a 6-Fr single universal guiding catheter (IL, Ikari-Left catheter; Terumo Corporation, Tokyo, Japan) in elective cases [12]. IL catheter is one of the universal catheters that is feasible for both transradial and transfemoral intervention [13], for both right and left coronary artery [14, 15], and coronary anomalies like high takeoff
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
