Reduction of bleeding complications on puncture site after percutaneous coronary intervention using a 6.5-French sheathless guiding catheter

• Published in: Heart and vessels Vol. 37; no. 6; pp. 954 - 960
• Main Authors: Akioka, Hidefumi, Yufu, Kunio, Harada, Taisuke, Akamine, Koshiro, Uemura, Tetsuya, Takahashi, Masaki, Nishimizu, Kyohei, Hirota, Kei, Ishii, Yumi, Kira, Shintaro, Yonezu, Keisuke, Abe, Ichitaro, Tawara, Katsunori, Kondo, Hidekazu, Saito, Shotaro, Fukui, Akira, Okada, Norihiro, Shinohara, Tetsuji, Teshima, Yasushi, Nakagawa, Mikiko, Takahashi, Naohiko
• Format: Journal Article
• Language: English
• Published: Tokyo Springer Japan 01.06.2022; Springer Nature B.V
• Subjects: Angioplasty; Biomedical Engineering and Bioengineering; Body mass; Body mass index; Body size; Cardiac Surgery; Cardiology; Catheters; Complications; Females; Hematoma; Hemorrhage; Males; Medical instruments; Medicine; Medicine & Public Health; Original Article; Peripheral neuropathy; Pseudoaneurysm; Regression analysis; Sheaths; Vascular Surgery; Percutaneous coronary intervention; Gender differences; Puncture site; Sheathless guiding catheters; Bleeding complications
• ISSN: 0910-8327; 1615-2573
• DOI: 10.1007/s00380-021-02005-8

Background Reducing complications at the puncture site after percutaneous coronary intervention (PCI) is important. The diameter of a 6.5-French (Fr) sheathless guiding catheter (GC) is smaller by approximately 2-Fr compared to a 6-Fr conventional sheath. In the present study, we investigated the post-PCI puncture site complications of a transradial approach in each gender while using a 6.5-Fr sheathless GC. Methods and results Our study consisted of 332 patients who underwent transradial coronary intervention (TRI) between August 2017 and July 2019. We classified the patients into either the 6.5-Fr sheathless GC (Asahi, Intecc, Aichi, Japan) Group (Sheathless group: n  = 182 males, 58 females) or the 6-Fr sheathed GC Group (Sheathed group: n  = 150 males, 36 females). We determined the complications at the puncture site: oozing, subcutaneous hemorrhage, formation of hematoma, pseudoaneurysms, and peripheral neuropathy. The body mass index of the patients was greater in the sheathless GC group compared to the sheathed GC group (24.5 ± 3.5 kg/m 2 vs. 23.6 ± 3.7 kg/m 2 , p  = 0.02). In males, there was no significant difference in the complication rate at the puncture site between the sheathless GC and sheathed GC groups (19.3% vs. 18.6%, p  = 0.88). However, the complication rate at the puncture site in females was higher in the sheathed GC group than in the sheathless GC group (36% vs. 15.5%, p  = 0.02). A multiple logistic regression analysis revealed that the use of a 6.5-Fr sheathless GC independently reduced the complications in female patients ( p  = 0.006). Conclusion The use of the 6.5-Fr sheathless GC system in a transradial approach reduced the complications at the puncture site in female patients. The 6.5-Fr sheathless GC system may be a safe option for them compared to the conventional sheath system.