Posted on Aug 05, 2009, 12 p.m.
Using smaller catheters in balloon angioplasty procedures can significantly reduce the number of deaths and the risk of complications, a multi-hospital study conducted in Michigan has found.
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