PERCUTANEOUS TRANSLUMINAL CORONARY ANGIOP LASTY WITH 6 FRENCH GUIDINGCATHETERS - A PRELIMINARY FEASIBILITY STUDY

This preliminary study was undertaken to assess the potential indicati on and limitations of the use of 6 French guiding catheters for percut aneous transluminal coronary angioplasty (PTCA). Between September 199 2 and October 1993, 100 consecutive patients with an average age of 64 +/- 11 years underwent 6 F angioplasty for: stable angina (38.7 %), u nstable angina (32.4 %), non Q-wave or infarction recanalised by throm bolytic therapy (18 %), and acute myocardial infarction (10.8 %). Eigh ty per cent of the pTCAs were performed immediately after diagnostic c oronary angiography. Single vessel disease accounted for 93.7 % of cas es. Of the 118 lesions treated, 46.6 % were types A or B1, 44.9 % were type B2 and 8.4 % were type C. The success rate of 6 F PTCA was 96.4 % using an average of 1.08 guides and 1.25 balloon catheters per patie nt. Stenosis decreased from 83 +/- 10 % to 26 +/- 16 %. There were 4 t echnical failures : in 1 case it was not possible to pass a chronic oc clusion, in 1 case coronary dissection was complicated by infarction, and in 2 cases a 7 F guiding catheter was required for successful PTCA . No patients required emergency coronary bypass surgery and there wer e no fatalities during the procedure. Four patients required perfusing balloon catheters and 8 were stented with a Palmaz-Schatz endoprosthe sis with the 6 F catheter. These results are comparable to those obtai ned with larger diameter guiding catheters. In view of the good corona ry ostial tolerance, the lower rate of local complications at the site of arterial punctum and the possibility of earlier mobilisation of pa tients after the procedure, the indications for 6 F PTCA should increa se.