Coronary angioplasty using an over‐the‐wire balloon catheter through a new 6 french guiding catheter

A new 6 French (F) guiding catheter with a large, teflon‐coated internal lumen (4.2F) was developed, permitting use of the standard ultralow profile (< 3F) over‐the‐wire system. This small coronary angioplasty system (6F‐PTCA) was evaluated in 48 lesions in 45 of 137 patients (33%) who underwent coronary angioplasty between September 1990 and January 1991. The mean age was 64 years (range 49 to 82); 37 (82%) were male. The procedure was via the brachial artery in 28 patients (62%). The overall primary success rate was 96%. It was 100% via the brachial artery and 90% via the femoral artery. There were no major complications. The puncture compression time with the 6F‐PTCA via the brachial artery and via the femoral and with 8F‐PTCA via the femoral was 3.8, 9.6, and 16.9 hr, respectively (P<0.001), although the procedure time of the 6F‐PTCA via brachial and via femoral and of the 8F‐PTCA was not significantly different. The mean hospital stay was 3.1, 4.5, and 5.5 days, respectively (P<0.01). A small hematoma occurred in 2 patients (4.4%) after the 6F‐PTCA and in 3 (3.3%) after 8F‐PTCA, and a large hematoma (>5 cm) was noted in 7 patients (7.6%) after 8F‐PTCA. These results indicate that coronary angioplasty using the over‐the‐wire system through the new 6F guiding catheter is technically feasible. Moreover, this approach, especially when advanced via the brachial artery, could shorten the he‐mostasis time and facilitate early ambulation. © 1992 Wiley‐Liss, Inc.