Material miniaturization during transradial approach

Michael Koutouzis, MD, PhD, FESC

Interventional Cardiologist,

2nd Department of Cardiology

Hellenic Red Cross General Hospital

Conflict of interest

- Astra Zeneca Hellas

- Lilly-Φαρμασερβ

- Galenica A.E.

- ELPEN A.E.

Why should we reduce material size?

- Improve patient comfort

- Reduce the incidence of RAO

Radial Artery Inner Diameter/Sheath Outer Diameter (RAID/SOD)

RAID/SOD ≥1 4%

RAID/SOD <1 13%

SHEATH OUTER DIAMETERS

4F 2mm

5F 2.3mm

6F 2.7mm

7F 2.85mm

8F 3.22mm

Reduce size by 1Fr

Sheathless Catheters

Reduce size 1-2 Fr

Reduce size 1-2 Fr

Sheathless Catheter preperation and insertion

Sheathless Catheter preperation and insertion

B

Insertion achieved using 5Fr x 125cm Shuttle Select diagnostic catheter

125cm 5Fr multipurpose diagnostic catheter

5 in 6Fr Guideliner Catheter

Dilator of a 4Fr 110cm sheath into 5Fr catheter

Partially inflated coronary balloon

High complication rate

13% Radial Artery occlusion11% early pseudoaneurysmal dilatation20% localized hematoma

Thank you