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Comparison of 4-French versus 5-French sheaths for diagnostic coronary angiography via the snuffbox approach
, 1, 2, 2, 2
Affiliations- Department of Cardiology, Bucheon St. Mary’s Hospital, The Catholic University College of Medicine, Seoul, Republic of Korea
- Department of Cardiology, Chonnam National University Hospital, Gwangju, Republic of Korea
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Abstract
Background: Although a shorter hemostasis duration would be expected when compared with the conventional radial approach as the diameter of the distal radial artery is smaller than that of the conventional radial artery, the optimal duration of hemostasis in diagnostic coronary angiography (CAG) via the distal radial approach, termed the snuffbox approach, has not been well investigated.
Methods: Data from 171 patients were retrospectively collected (55 and 116 patients in the 4-French [Fr] and 5-Fr sheath groups, respectively). The patients had suspected myocardial ischemia and were undergoing diagnostic CAG via the snuffbox approach at a single center between January 2019 and August 2019.
Results: The mean age of the study population was 67.6 ± 11.0 years, and 69% were male. The left snuffbox approach was performed in 146 (85.4%) patients. The mean snuffbox puncture time, defined as the time interval between local anesthesia and sheath cannulation, was 145.1 ± 120.8 s. The hemostasis duration was significantly shorter in the 4-Fr sheath group than in the 5-Fr sheath group (70 [62–90] vs. 120 [120–130] min; p < 0.001). There were local hematomas, defined as ≤ 5 cm in diameter, at the puncture site in 8 (4.7%) patients. Moreover, there were no conventional and distal radial artery occlusions, assessed by manual pulse, after hemostasis in the study population during hospitalization.
Conclusions: Successful hemostasis was obtained within 2 h for diagnostic CAG via the snuffbox approach using the 4-Fr or 5-Fr sheaths.
Abstract
Background: Although a shorter hemostasis duration would be expected when compared with the conventional radial approach as the diameter of the distal radial artery is smaller than that of the conventional radial artery, the optimal duration of hemostasis in diagnostic coronary angiography (CAG) via the distal radial approach, termed the snuffbox approach, has not been well investigated.
Methods: Data from 171 patients were retrospectively collected (55 and 116 patients in the 4-French [Fr] and 5-Fr sheath groups, respectively). The patients had suspected myocardial ischemia and were undergoing diagnostic CAG via the snuffbox approach at a single center between January 2019 and August 2019.
Results: The mean age of the study population was 67.6 ± 11.0 years, and 69% were male. The left snuffbox approach was performed in 146 (85.4%) patients. The mean snuffbox puncture time, defined as the time interval between local anesthesia and sheath cannulation, was 145.1 ± 120.8 s. The hemostasis duration was significantly shorter in the 4-Fr sheath group than in the 5-Fr sheath group (70 [62–90] vs. 120 [120–130] min; p < 0.001). There were local hematomas, defined as ≤ 5 cm in diameter, at the puncture site in 8 (4.7%) patients. Moreover, there were no conventional and distal radial artery occlusions, assessed by manual pulse, after hemostasis in the study population during hospitalization.
Conclusions: Successful hemostasis was obtained within 2 h for diagnostic CAG via the snuffbox approach using the 4-Fr or 5-Fr sheaths.
Keywords
coronary angiography, coronary catheterization, hemostasis, radial artery
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About this articleTitle
Comparison of 4-French versus 5-French sheaths for diagnostic coronary angiography via the snuffbox approach
Journal
Issue
Article type
Original Article
Pages
528-533
Published online
2020-01-09
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1522
Article views/downloads
1112
DOI
Pubmed
Bibliographic record
Cardiol J 2021;28(4):528-533.
Keywords
coronary angiography
coronary catheterization
hemostasis
radial artery
Authors
Ji Woong Roh
Hee-Yeol Kim
Youngkeun Ahn
Myung Ho Jeong
Yongcheol Kim
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