Percutaneous Transluminal Coronary Angioplasty Using 6 Fr Guiding Catheters: A Matched Study with 8 Fr Guiding Catheters

Abstract

Coronary angioplasty using 6 Fr guiding catheters has been described. This study was based on matching a prospective 105 coronary angioplasty procedures performed using 6 Fr guiding catheters (group I) with 100 other prospectively collected procedures performed through 8 Fr catheters (group II). Procedural variables such as quantity of contrast injected, total duration of the angioplasty, and vessel opacification were collected, as well as the success rate and local vascular complications. The two groups were identical regarding the baseline clinical and angiographic characteristics (age, sex, clinical indication, type of the lesion, and the size of the artery attempted). Success rate was similar between both groups (94.2% and 95% for groups I and II, respectively). Cross‐over from 6 Fr to 8 Fr system was needed in two cases (one for inadequate back‐up support, the other for a long dissection and inadequate vessel opacification). The use of 6 Fr guiding catheters was possible in such acute situations as myocardial infarction or scent delivery for coronary dissections. The quantity of contrast injected through the 6 Fr catheters (164 ± 74 mL) was significantly less than through the 8 Fr ones (217 ± 92 mL; P ± 0.01). On the other hand, the mean duration of the procedure was slightly longer using the 6 Fr system (40 ± 18 min vs 34.4 ± 18 min for groups I and II, respectively; P < 0.02). There was no difference between the two groups regarding the local vascular complications. This study demonstrates the feasibility of PTCA using 6 Fr guiding catheters in a variety of clinical indications, with a smaller quantity of contrast than in the 8 Fr ones, but a slightly longer duration. The other potential advantages of 6 Fr guiding catheters (lower rate of local complications, less blood loss) have not been proven in this study. (J Interven Cardiol 1996;9:373–379)