From AM, Gulati R, Prasad A, Rihal CS. The Division of Cardiovascular Diseases, Mayo Clinic College of Medicine and Mayo Foundation Rochester, Minnesota.

OBJECTIVES: Our aim was to report our preliminary experience performing complex transradial interventions using a sheathless technique with standard large bore non-hydrophilic guiding catheters.

BACKGROUND: A major limitation of transradial PCI is the inability to use large guides because of the relatively small size of the radial artery.

METHODS: We identified consecutive patients who had transradial PCI between September 2009 through March 2010 using large-bore guides (7 or 8 Fr) with a sheathless technique.

RESULTS: Ten patients were identified (90% male, mean age 68.8 +/- 9.8 years). Indications for PCI were stable angina (60%) and acute coronary syndrome (40%). Treatment was attempted on 15 vessels. Bifurcation lesions were present in 6 patients. One patient had a chronic total occlusion, one had a saphenous vein bypass graft lesion requiring filter wire placement prior to intervention and one patient required rotational atherectomy. In the majority of patients (60%) a 7 Fr guiding catheter was utilized for the intervention; 8 Fr guide catheters were used 4 patients. PCI was unsuccessful in one vessel; this was a completely occluded obtuse marginal which could not be crossed. There were no radial artery access site complications and in no case was cross-over to a femoral artery access site required. One minor coronary complication occurred. CONCLUSIONS: Sheathless transradial PCI using standard large-bore guiding catheters is a safe and effective method for treatment of complex lesions

Catheter Cardiovasc Interv. 2010 Sep 7. [Epub ahead of print]