Feasibility and Safety of Performing Complex Coronary Interventions by Distal Radial Artery Using the Railway Sheathless Vascular System.

Aims The aim of this clinical study is to assess the feasibility and safety of the 7 Fr Railway sheathless access system (Cordis Corporation) for complex percutaneous coronary interventions (PCI) using distal radial artery access. Methods and results Over a 2-month period, we enrolled 20 patients (all those undergoing complex PCI) where a 7 Fr guide catheter was deemed necessary. Multiple bifurcation techniques and calcified plaque modifying tools were used. The primary endpoint was procedural success (95%) without need for access-site crossover (0%) or major adverse cardiovascular event within the first month (0%), while our secondary endpoint was the access-site complication rate (arterial spasm in 1 case [5%]). Conclusion Distal radial access with the 7 Fr Railway sheathless access system was a feasible and safe access option for complex PCI in our very high-risk study population. This approach could be a valuable option for decreasing the risk of a major bleeding event or vascular complication in cases that require a large guide catheter.