CORONARY ANGIOPLASTY THROUGH A NEW 6 FRENCH GUIDING CATHETER

Coronary angioplasty through smaller-diameter guiding catheters using predominantly fixed-wire balloon systems has been possible, but has ha d some limitations. The purpose of this prospective, nonrandomized stu dy was to investigate the results of percutaneous transluminal coronar y angioplasty using a new 6F guiding catheter with over-the-wire ballo on systems. Coronary angioplasty using over-the-wire balloon systems t hrough a new 6F guiding catheter was evaluated in 79 lesions in 70 pat ients and then compared to randomly selected procedures using 7F guidi ng catheters in 70 patients performed over the same time period. Coron ary angioplasty through 6F guiding catheters and over-the-wire balloon s including 8 long (30-mm) and 3 perfusion balloons was successful in 94.9% of lesions and in 94% of patients. Coronary angioplasty through 7F guiding catheters was successful in 97.5% of lesions and in 97.1% o f patients, respectively. Success rates between 6F and 7F guiding cath eter groups were similar overall and for proximal, mid, distal, or com plex (total, subtotal, or length >10-mm) lesions. There were no failur es to withdraw the deflated balloon into the 6F guiding catheter. Vess el opacification after dilatation with the guidewire across the lesion was similar between the 6F and 7F guiding catheter groups. The mean c hange in hematocrit for the 6F procedures (-1.4+/-3.7%) was significan tly lower than for the 7F procedures (-3.3+/-3.2%, P<0.001). Coronary angioplasty using a variety of over-the-wire balloon catheters through a new 6F guiding catheter is feasible with success rates comparable t o 7F guiding catheters. Angioplasty with this 6F guiding catheter redu ces procedural blood loss compared to larger-lumen guiding catheters. (C) 1994 Wiley-Liss, Inc.