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Research paper
Published online: 2020-01-09
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Comparison of 4-French versus 5-French sheaths for diagnostic coronary angiography via the snuffbox approach

Ji Woong Roh, Hee-Yeol Kim, Youngkeun Ahn, Myung Ho Jeong, Yongcheol Kim
DOI: 10.5603/CJ.a2020.0003
·
Pubmed: 31960944

open access

Ahead of print
Original articles
Published online: 2020-01-09

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.

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Keywords

coronary angiography, coronary catheterization, hemostasis, radial artery

Supplementary Files (1)
Supplementary Video 1. Hemostasis of the snuffbox approach by compressive bandage method.
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About this article
Title

Comparison of 4-French versus 5-French sheaths for diagnostic coronary angiography via the snuffbox approach

Journal

Cardiology Journal

Issue

Ahead of print

Article type

Research paper

Published online

2020-01-09

DOI

10.5603/CJ.a2020.0003

Pubmed

31960944

Keywords

coronary angiography
coronary catheterization
hemostasis
radial artery

Authors

Ji Woong Roh
Hee-Yeol Kim
Youngkeun Ahn
Myung Ho Jeong
Yongcheol Kim

References (19)
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