Abstract
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 4βFr coronary accessor. Methods: A total of 31 patients underwent 4βFr PCI. Exclusion criteria for 4βFr 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 4βFr 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%). FourβFr 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 6βFr 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 accessβsite related complications including radial artery occlusion were observed. Conclusions: PCI with a 4βFr coronary accessor is a viable alternative to the use of larger guide catheters. The advent of 4βFr stent delivery system may afford a less invasive approach for the treatment of patients with coronary artery disease. Β© 2008 WileyβLiss, Inc.