Title : The impact of slender DCA

Background: DCA catheter (Atherocut; Nipro, Japan) usually need 8Fr guiding catheter because of its contrast effect however it is compatible for 7Fr guiding catheter. The aim of this study is to assess the clinical outcome of radial DCA with 7Fr guiding catheter.

Methods: Consecutive 125 patients with 130 lesions, who was diagnosed as stable angina pectoris or acute coronary syndrome, was enrolled between July 2018 to January 2021, and were divided into 2 groups: 8Fr-femoral (n=82) and 7Fr-radial (n=48). We assessed lesion characteristics (preMLA, pre % plaque area), post procedural endpoint (postMLA, post % plaque area), procedural success, procedural complication and access site complication. In radial group, 4Fr diagnostic catheter was used for angiography via brachial or distal radial approach.

Results: 7Fr-radial group had the same lesion characteristics (pre- MLA: 4.65±2.17 mm2 vs 4.60±1.79 mm2, p=0.913, pre % plaque area: 69.47±12.39 vs 72.82±10.16, p=0.150), post procedural endpoint (post MLA: 9.11±2.98 mm2 vs 9.00±2.48 mm2, p=0.833, post % plaque area:47.11±9.81 vs 48.15±9.47, p=0.615), procedural success (100% vs 100%, p=1.00), procedural complication (0 (0%) vs 4 (1; deep cut, 1; perforation, 2: slow flow) (4.9%), p=0.296) and access site complication (0 (0%) vs 5 (2; aneurysm, 3; transfusion) (6.1%), p=0.157). Usage of contrast dye was significantly lower in radial group (88.62±33.86 ml vs 105.60±44.64 ml, p<0.05).

Conclusion: Radial DCA was as safe and effective as femoral approach in acute phase, moreover, could contribute to reduction of puncture site complication and contrast dye.

The author is an cardiologist specializing in interventional cardiology. He holds a PhD in Cardiology from Nagoya University. He has published extensively on complex PCI including CTO, Rotablator and DCA, who has also performed live demonstration cases in domestic and international conference. He is currently the Director of the Cardiology at the Nagoya Ekisaikai Hospital.