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Larger Guide Catheters in PCI Linked to Complications

7-F, 8-F guides associated with vascular complications, other issues compared to 6-F

WEDNESDAY, July 22 (HealthDay News) -- The use of 7-F and 8-F guides for percutaneous coronary intervention (PCI) is associated with a greater risk of a variety of complications compared with 6-F guides, according to research published in the July issue of the Journal of the American College of Cardiology: Cardiovascular Interventions.

P. Michael Grossman, M.D., of the University of Michigan Hospitals and Health Center in Ann Arbor, and colleagues analyzed data from more than 100,000 patients undergoing PCI using 6-F, 7-F, or 8-F guide catheters. Roughly 6 percent of procedures were done with the 8-F size.

In multivariate analysis, the researchers found that the larger guides were associated with the use of more contrast medium and a greater risk of contrast-induced nephropathy, vascular complications, and post-procedure transfusion. The use of 8-F guides was associated with greater risk of major adverse cardiac events and in-hospital mortality.

"Importantly, these findings are from a multicenter registry and include data gathered prospectively from procedures performed by more than 100 interventionalists and, therefore, represent a large cross-section of contemporary interventional cardiology practice," the authors write. "The data from this study suggest that the use of smaller guiding catheters during PCI is associated with significantly better outcome, including improved post-procedural morbidity and reduced mortality."

The study was supported by a grant from Blue Cross Blue Shield of Michigan.

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