PMID- 30158323
OWN - NLM
STAT- MEDLINE
DCOM- 20181211
LR  - 20220408
IS  - 1557-2501 (Electronic)
IS  - 1042-3931 (Linking)
VI  - 30
IP  - 9
DP  - 2018 Sep
TI  - Transradial Intervention in Patients With Non-ST Elevation Acute Coronary 
      Syndrome Using One 4.0 Fr Sheath and One Sheathless Guide Catheter Via a Single 
      Puncture Site: The 1-1-1 Strategy.
PG  - 316-323
AB  - OBJECTIVES: The optimal primary transradial intervention (TRI) technique has not 
      been established in non-ST segment elevation acute coronary syndrome (NSTEACS) 
      patients, because they often, but not always, undergo immediate revascularization 
      after coronary angiography (CAG). Moreover, TRI failure has been reported in 
      5%-10% of cases. We investigated whether a newly designed strategy of immediate 
      TRI using one sheathless hydrophilic-coated guiding catheter (SH-GC) after 
      diagnostic CAG with one 4.0 Fr sheath via a single access site (the 1-1-1 
      strategy) could be beneficial for NSTEACS patients. METHODS: We performed 
      immediate TRI prospectively using SH-GC in consecutive NSTEACS patients in our 
      hospital and compared the procedural success rate with that of conventional TRI 
      performed before this study. RESULTS: Between 2015 and 2017, immediate TRI using 
      SH-GC was performed in 330 consecutive NSTEACS patients after CAG using a 4.0 Fr 
      sheath. Compared with the conventional TRI group (n = 330), the procedural 
      success rate was significantly higher in the SH-GC group (P<.01), as SH-GC 
      prevented TRI failure due to radial spasm (P<.01). SH-GC use was also 
      significantly associated with completion of both diagnostic CAG and immediate TRI 
      using only one sheath (P<.001) and one guiding catheter (P=.02). Multivariate 
      analysis revealed that SH-GC use was an independent predictor of successful TRI 
      (P<.01). The rates of major adverse cardiac events were comparable; however, 
      rates of major access-site bleeding (P<.01) and blood transfusion (P=.02) were 
      significantly lower in the SH-GC group. CONCLUSIONS: The 1-1-1 strategy using 
      SH-GC may offer better TRI treatment than conventional systems for NSTEACS 
      patients and simultaneously prevent access-site bleeding.
FAU - Horie, Kazunori
AU  - Horie K
AD  - Division of Cardiovascular Medicine, Sendai Kousei Hospital, 4-15 Hirose-cho, 
      Aoba-ku, Sendai, Miyagi 980-0873, Japan. horihori1015@gmail.com.
FAU - Tada, Norio
AU  - Tada N
FAU - Isawa, Tsuyoshi
AU  - Isawa T
FAU - Matsumoto, Takashi
AU  - Matsumoto T
FAU - Taguri, Masataka
AU  - Taguri M
FAU - Kato, Shigeaki
AU  - Kato S
FAU - Honda, Taku
AU  - Honda T
FAU - Ootomo, Tatsushi
AU  - Ootomo T
FAU - Inoue, Naoto
AU  - Inoue N
LA  - eng
PT  - Journal Article
PL  - United States
TA  - J Invasive Cardiol
JT  - The Journal of invasive cardiology
JID - 8917477
SB  - IM
MH  - Acute Coronary Syndrome/diagnosis/*surgery
MH  - Aged
MH  - *Cardiac Catheters
MH  - Coronary Angiography
MH  - Equipment Design
MH  - Feasibility Studies
MH  - Female
MH  - Follow-Up Studies
MH  - Humans
MH  - Male
MH  - Percutaneous Coronary Intervention/*methods
MH  - Prospective Studies
MH  - Punctures/*methods
MH  - Radial Artery
MH  - Treatment Outcome
OTO - NOTNLM
OT  - access-site management
OT  - acute MI
OT  - radial artery access
EDAT- 2018/08/31 06:00
MHDA- 2018/12/12 06:00
CRDT- 2018/08/31 06:00
PHST- 2018/08/31 06:00 [entrez]
PHST- 2018/08/31 06:00 [pubmed]
PHST- 2018/12/12 06:00 [medline]
PST - ppublish
SO  - J Invasive Cardiol. 2018 Sep;30(9):316-323.