Feasibility of single transradial MAC guiding catheter for coronary angiography and intervention in patients with ST elevation myocardial infarction

doi:10.3969/j.issn.1006-7795.2015.01.015

Abstract

Abstract: Objective To investigate the feasibility of using a single guiding catheter (MAC 3.5) for left and right coronary angiography and intervention in patients with ST segment elevation myocardial infarction (STEMI).Methods This was a single-center, prospective, randomized study conducted from August 2011 to April 2012; Totally 150 patients with STEMI indicated for transradial primary PCI performed by an experienced transradial operator were randomized into two groups: MAC group (75 cases) consisted of patients who underwent coronary angiography and primary PCI by using a single guiding catheter (MAC3.5). Control group (75 cases) included patients who first underwent coronary angiography with Tiger diagnostic catheter followed by guiding catheter selection at the operator's discretion for intervention. The primary outcomes were procedural time and fluoroscopic time. The secondary outcomes were complications of puncture site and composite of all-cause death, myocardial infarction or non-coronary artery bypass graft (non-CABG)-related major bleeding at 30 days. Analysis was done by intention to treat mode.Results Baseline patient characteristics were similar between the MAC group and control group. Crossover from radial access to femoral access (4.0% vs 3.5%), guiding catheter exchange rate (10.7% vs 9.3%), procedure time of coronary angiography[(7.2±2.6) min vs (7.1±2.3) min] and door to balloon time [(86.1±39.4)min vs (88.8±36.3)min] in the two groups were not statistically significant (P>0.05), respectively. Compared with the Control group, PCI procedure time, total procedure time and the overall fluoroscopy time were significantly shorter in MAC group[(23.7±9.6)min vs (29.0±12.0)min, P=0.003; (30.9±10.4) min vs (36.4±12.3)min, P=0.004; (8.4±2.1)min vs (10.2±4.9)min, P=0.007, respectively]. Local hematoma occurred in 3 cases in each of the two groups that improved after physiotherapy. The composite endpoints at 30 days was 6.6%(5/75)in the MAC group compared with 5.3%(4/75)in the control group (χ²=0.118, P=0.731), respectively.Conclusion A single transradial MAC 3.5 guiding catheter for coronary angiography and intervention seems to be a better option for patients with STEMI for whom primary PCI is planned. It can shorten PCI procedure time and fluoroscopy time. Further study is required to determine whether this strategy can favorably affect clinical outcomes.

Key words: myocardial infarction, angioplasty, radial artery, catheter

CLC Number:

R542.2

Guo Jincheng, Wang Guozhong, Zhu Fuli, Chen Wenming, Liu Zijing, Xu Rong, Zhang Libin. Feasibility of single transradial MAC guiding catheter for coronary angiography and intervention in patients with ST elevation myocardial infarction[J]. Journal of Capital Medical University, 2015, 36(1): 78-83.

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URL: https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/10.3969/j.issn.1006-7795.2015.01.015

https://journal03.magtech.org.cn/Jweb_sdykdxxb/EN/Y2015/V36/I1/78

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