Percutaneous Coronary Intervention Complications and Guide Catheter Size

• Published in: JACC. Cardiovascular interventions 2009-07, Vol.2 (7), p.636-644
• Main Authors: Grossman, P. Michael, MD, Gurm, Hitinder S., MD, McNamara, Richard, MD, LaLonde, Thomas, MD, Changezi, Hameem, MD, Share, David, MD, MPH, Smith, Dean E., PhD, Chetcuti, Stanley J., MD, Moscucci, Mauro, MD
• Format: Article
• Language: English
• Subjects: Cardiovascular; coronary guide catheter size; coronary intervention complications; coronary intervention outcomes; percutaneous coronary intervention
• ISSN: 1936-8798; 1876-7605
• DOI: 10.1016/j.jcin.2009.05.012

Percutaneous Coronary Intervention Complications and Guide Catheter Size: Bigger Is Not Better P. Michael Grossman, Hitinder S. Gurm, Richard McNamara, Thomas LaLonde, Hameem Changezi, David Share, Dean E. Smith, Stanley J. Chetcuti, Mauro Moscucci, for the Blue Cross Blue Shield Michigan Cardiovascular Consortium (BMC2) We studied the impact of guiding catheter size on complications and outcomes associated with percutaneous coronary intervention (PCI). Variables from patients collected in a multicenter consortium undergoing PCI from 2001 through 2006 with 6-F guides (n = 64,335) were compared with those undergoing PCI with 7-F guides (n = 32,676) or 8-F guides (n = 6,059). After adjustment, larger guides were associated with a significantly higher risk of contrast-related nephropathy, vascular complications, post-procedure transfusion, and 8-F guides with major adverse cardiovascular events and in-hospital mortality. These data suggest that selection of smaller guide catheters may result in improved clinical outcome in patients undergoing contemporary PCI.