Researchers from the University of Michigan
Health System conducted one of the largest studies of its kind to evaluate if
the size of catheters used in angioplasty procedures impacts death rates and
rates of complications. The investigators looked at data from 31 hospitals
across Michigan that participate in the Blue Cross Blue Shield of Michigan
Cardiovascular Consortium — a statewide collaborative effort focused on
improving patient safety and quality of care.
They discovered that of those 103,000
patients who had coronary interventions in the past five years, death rates
were more than 30 percent higher in patients who had procedures involving the
larger 8F catheter than procedures done with the smaller 6F catheter. In addition,
the team of researchers also found that in those patients who had the larger
catheters, there was a significantly higher incidence of complications,
including kidney damage, the need for blood transfusions and the need for
emergency open heart surgery.
“While overall
death rates associated with PCIs (stents) are still low, the decision to use a
smaller catheter significantly and independently increases the chance for
patient survival and decreases the likelihood of other serious complications,” says lead author Paul Michael Grossman, M.D., assistant professor of
internal medicine at the U-M Medical School and director of the VA Ann Arbor
Cardiac Catheterization Laboratory. The results of the multi-hospital study,
which were published in the July 28 issue of the Journal of American College of
Cardiology Cardiovascular Interventions, may help guide choices that
cardiologists make and potentially influence the development of devices
designed to treat coronary artery disease.
Data collected
for the study also revealed that some cardiologists in the group already prefer
the smaller catheters because of their link to fewer vascular complications and
faster recovery. However, due to perceived ease of use and the recommendations
of some medical textbooks, the majority of interventionists still use larger
catheters. Blue Cross Blue Shield of Michigan funded the study.
News Release: Bigger is not better in catheter
use for angioplasty www2.med.umich.edu July 27, 2009
